いわゆる潜在性高prolactin血症の黄体機能に及ぼす影響

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It is well known that the luteal function in the patients with hyperprolactinemia is much suppressed by high level of serum prolactin. Present study was performed to investigate whether the luteal function in the patients with transient or occulted hyperprolactinemia was affected by the transient increase of serum prolactin level.<BR>The circadian changes of serum FSH, LH, prolactin, estrone, estradiol and progesterone levels were examined in seven cases of the transient or occulted hyperprolactinemia whose BBT charts showed biphasic patterns. Serum prolactin levels of these patients were less than 25 ng/ml at daytime and more than 150 ng/ml at 30 minutes after the administration of 500 μg of TRH. Blood samplings were taken every two hours through an intravenous indwelling catheter without any disturbances. All of the patients had their breakfast at 7 to 8, lunch at 11 to 12 and dinner at 17 to 18 o'clock and slept from 22 until 6 in the next morning. Serum FSH, LH, prolactin, estrone, estradiol and progesterone levels were determined by RIA and the circadian changes of these hormones were analysed. Then, 5 mg of bromocriptine was administered every day to these patients for more than 30 days and the duration of the luteal phase and the mid-luteal serum estradiol and progesterone levels for the indicators of the luteal function were examined before and after the administration of bromocriptine.<BR>The circadian changes of serum prolactin levels in the patients showed significant increase during both daytime and night compared to those of the control (p<0.005, p<0.005). Moreover, serum prolactin levels of the patients during night also showed significant increase compared to those during daytime (p<0.005). There was no conspicuous change in the circadian profiles of serum FSH, LH, estrone and estradiol levels. However, the circadian profile of serum progesterone levels showed significant decrease during night in the patients with transient or occulted hyperprolactinemia, and the significant negative correlation could be seen between serum prolactin and progesterone levels (r=-0.6404, p<0.005). By the administration of bromocriptine, the luteal phase period of the pateints was prolonged significantly (p<0.005) and the mid-luteal serum estradiol and progesterone levels also showed significant increase (p<0.005, p<0.005).<BR>From these facts, it was concluded that the luteal function of these patients were disturbed even by the transient increase of serum prolactin levels and suggested that the transient increase of serum prolactin levels might suppress the luteal function directly. And the administration of bromocriptine was very effective to improve the luteal insufficiency of these patients.
一般社団法人日本内分泌学会の論文

いわゆる潜在性高prolactin血症の黄体機能に及ぼす影響

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