苏雅琴 张宁宁 梁小青 张少静 魏永志

[摘要] 目的 探讨Cabergoline在治疗女性高泌乳素血症患者月经异常与泌乳等方面的应用价值。 方法 选取石家庄市第一医院妇科2014年6月～2017年6月诊治的高泌乳素血症患者作为研究对象，依据随机数字表法分组，观察组（n = 45）采用Cabergoline治疗，对照组（n = 45）采用溴隐亭治疗。记录两组治疗后血清泌乳素值变化情况、临床症状疗效、药物不良反应发生率以及耐药情况。 结果 观察组用药后2、3个月的血清泌乳素水平均低于对照组（P < 0.05）；观察组月经异常的治疗有效率高于对照组（P < 0.05）；两组溢乳和视力下降、头痛等其他症状的治疗有效率比较差异无统计学意义（P > 0.05）；观察组恶心呕吐、低血压和精神症状不良反应发生率均低于对照组（P < 0.05）；两组耐药率比较，差异无统计学意义（P > 0.05）。 结论 与溴隐亭比较，Cabergoline治疗女性高泌乳素血症患者降泌乳素效果更好、月经异常症状改善也更明显，同时药物不良反应发生率更低。

[关键词] Cabergoline；高泌乳素血症；溴隐亭；月经异常

[中图分类号] R711.6 [文献标识码] A [文章编号] 1673-7210（2018）10（b）-0079-04

[Abstract] Objective To explore the application value of Cabergoline in the treatment of abnormal menstruation and galactorrhea in women with hyperprolactinemia. Methods Patients with hyperprolactinemia treated from June 2014 to June 2017 in the First Hospital of Shijiazhuang City were selected. They were divided into two groups according to the random number table. The observation group （n = 45） was treated with Cabergoline， while the control group （n = 45） was treated with Bromocriptine. Before and after treatment， the changes of the serum prolactin value， the clinical symptom effect， the incidence of drug adverse reaction and the drug resistance of the two groups were recorded. Results The serum prolactin values of observation group at 2 and 3 months after treatment were lower than those of control group （P < 0.05）. The effective rate of abnormal menstruation in observation group was higher than that of control group （P < 0.05）. There was no statistically significant difference in treatment efficiency between the two groups for galactorrhea， visual impairment， headache and other symptoms （P > 0.05）. The incidence of adverse reaction such as nausea， vomiting， hypotension， and mental symptoms in observation group were lower than those in control group （P < 0.05）. There was no statistically significant difference in drug resistance rate between two groups （P > 0.05）. Conclusion Compared with the Bromocriptine， Cabergoline has better effect on reducing prolactin value， improvement of abnormal menstruation and lower incidence of drug adverse reactions in women with hyperprolactinemia.

[Key words] Cabergoline； Hyperprolactinemia； Bromocriptine； Abnormal menstruation

高泌乳素血癥是女性常见的妇科内分泌疾病，由于泌乳素水平检查未被列入常规体检范围，该病又涉及学科交叉领域，因此难以估计该病发病率[1]。女性高泌乳素血症患者主要表现为月经稀发、闭经等月经异常和溢乳等症状，影响正常工作生活，严重者造成不孕或并发垂体肿瘤等[2]。指南中已明确指出多巴胺（Dopamine）受体激动剂治疗为该病的首选治疗方案，多年来国内将溴隐亭（Bromocriptine）作为主要治疗药物，但该药的不良反应和耐药情况往往不令人满意[3]。Cabergoline是一种长效的Dopamine受体激动剂，能够在下丘脑和垂体水平抑制泌乳素的合成与分泌，达到降低血清泌乳素水平和改善临床症状目的，已在国外广泛使用[4]。……