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词汇介绍
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解析
Hyperprolactinemia
释 义 n. 乳素血症;[内科] 高泌乳素血症
例 句 Hyperprolactinemia is one of the common diseases to cause the amenorrhea, galactorrhea and dysgenesis. 高催乳素血症是引起闭经、溢乳、不孕等常见疾病之一。
概述
概述
高催乳素血症是以血液中称为催乳激素的激素水平高为特征的状态。催乳素是由垂体产生的,在怀孕期间乳房的发育中起着至关重要的作用。虽然高催乳素血症在怀孕和哺乳期间被认为是完全正常的,但由于疾病和药物使用,它可能在其他时间发生。高催乳素血症可影响男性和女性,导致月经不调和勃起功能障碍。
病理原因
高催乳素血症的一个常见原因是垂体上的肿瘤,称为催乳素瘤,肿瘤可产生高水平的催乳激素。这些肿瘤可大可小,通常是良性的,这意味着它们没有癌变。大型肿瘤也可能导致头痛,视力问题或两者兼而有之。催乳素瘤在女性中比在男性中更常见,在儿童中很少发生。
某些处方药也会增加催乳素水平,这些药物包括:抗高血压药(例如钙通道阻滞剂和甲基多巴);治疗抑郁症的药(三环和SSRI抗抑郁药);治疗胃灼热和胃食管反流病的药物;治疗恶心和呕吐的药物;治疗疼痛的药物(鸦片-来自鸦片的药物);避孕药;治疗严重的心理健康疾病的药物(抗精神病药,如利培得和氟哌啶醇);治疗更年期症状的药物(雌激素)。
其他原因包括:甲状腺功能低下-意味着甲状腺无法产生足够的甲状腺激素;胸壁受伤或影响胸壁的其他状况,例如带状疱疹;影响垂体的其他肿瘤和疾病,或垂体上或垂体附近的肿瘤的放射治疗;慢性肝肾疾病。
临床表现
女性高泌乳素血症的症状可能有所不同,当发生在怀孕或母乳喂养之外时,它们可能会表现为以下症状:不孕不育;泌乳异常;闭经(排卵期消失);性欲丧失;乳房疼痛;阴道干燥导致性交疼痛。
当在男性中发生时,症状通常涉及性功能障碍和/或与催乳素瘤形成相关的疼痛。常见的症状和体征包括:勃起功能障碍;男性乳房发育(乳房组织发育);不孕不育;性欲丧失。
诊断
高泌乳素血症的诊断包括常规血液检查以检查泌乳素水平。如果血液水平升高,医生可能要在禁食至少八个小时后再次进行检查。女性正常催乳素水平低于500 mIU/L,男性低于450 mIU/L,磁共振成像(MRI)扫描可以寻找一个垂体生长的证据或用于对周围组织的损害评估,其他激素水平的血液测试可能有助于排除症状的任何其他可能原因。
治疗
治疗的目的是使泌乳素恢复到正常水平,有许多标准选项可以实现此目的:已知溴隐亭和卡麦角林可有效降低催乳素水平和缩小垂体肿瘤;如果药物不起作用或耐受性差,有时可使用手术切除垂体瘤;如果药物和手术效果不佳,则建议使用放射疗法,尽管很少使用;甲状腺功能减退可以用合成的甲状腺激素治疗,应降低催乳素水平;如果催乳素水平过高是由处方药引起的,则可以开具替代药物。
Evidence for hyperprolactinemia in migraineurs: a systematic review and meta-analysis复制标题
偏头痛患者高催乳素血症的证据: 系统回顾和荟萃分析
发表时间:2019-08-23
影响指数:2.5
作者: Ali Noori-Zadeh
期刊:Neurol Sci
Migraine is characterized by recurrent headaches that are often throbbing in sensation and frequently unilateral in location and severe in intensity. From the etiology aspects, it is thought that migraine is a form of neuro-vascular headache, i.e., a disorder in which during an attack, the neural abnormality occurs and results in blood vessel dilation, which, in turn, causes pain induction and brain nociceptive activation. Thus, migraine is best understood as a primary disorder of the brain tissue which is triggered by primary brain biochemical homeostasis instabilities and disturbances and vascular tone changes are known as the secondary event. Although migraine attacks may occur at any age, it is notable that they are frequently appeared in childhood, especially during puberty periods. It affects women more than men as the 1-year migraine prevalence is nearly threefold higher and the cumulative lifetime incidence is more than twofold higher in comparison with men. The most prevalent subtype is migraine without aura, including menstrual migraine in women. Interestingly, migraine is more prevalent in women during reproductive years and it is well known that there is a strong relationship between headache and endocrine homeostasis, particularly in relation to ovarian hormones. It is thought that hormones acting in the hypothalamus-pituitary-ovaries axis are critically important in the pathophysiology of migraine. Of this axis, prolactin is secreted from anterior pituitary gland and synthesized by a variety of immune system cells. Even though there is a plethora of publications describing prolactin blood concentrations from 1970s to 2010s, however, there is not any meta-analysis in the evidence-based medicine field and actually, whether prolactin circulatory concentrations can be altered during migraine pathogenesis is an open question yet. Therefore, investigating prolactin blood levels in migraineurs may pave the way to underpin our understanding about migraine pathophysiology at biochemical levels. In the current report, the prolactin blood levels in the migraine subjects investigated using meta-analysis under random-effects model and SMD as the effect size.
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