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目的探讨甲磺酸溴隐亭对垂体催乳素(PRL)大腺瘤所致不孕症的治疗效果。方法选择41例垂体PRL腺瘤不孕女性患者,按肿瘤大小分为研究组(瘤体直径≥1.0cm)15例和对照组(瘤体直径<1.0cm)26例,采用溴隐亭治疗,1、3、6个月行垂体MRI扫描、血PRL测定及B超监测排卵情况。结果研究组治疗后6个月临床症状完全消失、PRL正常或低于治疗前50%水平、肿瘤消失或体积缩小>50%的患者分别为12例(80.0%)、12例(80.0%)和13例(86.7%),对照组分别为22例(84.6%)、21例(80.8%)和22例(84.6%),两组比较,差异均无统计学意义(P>0.05);研究组B超监测有排卵、成功妊娠及足月分娩患者分别为12例(80.0%)、11例(73.3%)和11例(73.3%),对照组分别为23例(88.5%)、22例(84.6%)和20例(76.9%),两组比较,差异均无统计学意义(P>0.05)。产后随访6~12个月,研究组中肿瘤体积轻度增大1例,对照组无明显改变。结论溴隐亭对垂体PRL大腺瘤和微腺瘤所致不孕的治疗效果相当,可单独用于治疗PRL大腺瘤合并不孕患者。
Objective To investigate the therapeutic effect of bromocriptine mesylate on infertility induced by pituitary prolactin (PRL) macroadenoma. Methods Forty-one patients with pituitary adenoma PRL adenomas were divided into study group (diameter of tumor ≥1.0cm) and control group (diameter of tumor less than 1.0cm) in study group (26cases) by bromocriptine treatment, 1,3,6 months pituitary MRI scan, blood PRL measurement and B-monitoring of ovulation. Results The clinical symptoms of the study group disappeared completely at 6 months after treatment, with 12 patients (80.0%) and 12 patients (80.0%) with PRL normal or lower than 50% before treatment, tumor disappearance or volume reduction> 50% (86.7%) in control group, 22 cases (84.6%), 21 cases (80.8%) and 22 cases (84.6%) in control group. There was no significant difference between the two groups (P> 0.05) 12 cases (80.0%), 11 cases (73.3%) and 11 cases (73.3%) were diagnosed ovulation, successful pregnancy and full-term delivery by B ultrasound. The control group were 23 cases (88.5%) and 22 cases 84.6%) and 20 cases (76.9%). There was no significant difference between the two groups (P> 0.05). Postpartum follow-up of 6 to 12 months, the study group, a slight increase in tumor volume in 1 case, no significant change in the control group. Conclusion Bromocriptine has the same treatment effect on infertility induced by pituitary adenoma and microadenoma, and can be used alone in the treatment of PRL adenoma complicated with infertility.