Ib qho tshuaj hormones tseem ceeb rau kev vam meej ntawm kev pub niam mis, prolactin tau tso tawm hauv cov koob tshuaj siab thaum kawg ntawm cev xeeb tub thiab hauv lub lis piam tom qab yug menyuam. Txawm li cas los xij, sab nraud ntawm lub sijhawm perinatal no, cov qib prolactin siab tuaj yeem cuam tshuam rau fertility. Kev piav qhia.

Prolactin yog ib qho tshuaj hypohyseal. Nws lub luag haujlwm: npaj lub mis los tsim cov kua mis thiab txhawb kev loj hlob ntawm cov qog mammary los ntawm kev puberty rau cov poj niam. Hauv ob qho tib si poj niam txiv neej, nws muaj kev tawm tswv yim ntawm cov hlwb hypothalamic uas zais GnRH (hormone uas txhawb kev tsim cov tshuaj hormones poj niam txiv neej.)

Secreted thaum lub sij hawm cev xeeb tub thiab sab nraum cev xeeb tub, thoob plaws hauv lub hnub, nws txawv nyob rau hauv cov nyhuv ntawm ntau yam:

• noj zaub mov muaj protein ntau los yog qab zib,
• pw tsaug zog, - kev ntxhov siab (lub cev lossis lub hlwb),
• ua tau tshuaj loog,
• noj qee yam tshuaj.

Kev tsim tawm ntawm prolactin kuj hloov pauv thaum lub caij coj khaub ncaws. Nws yog li nce mus txog nws qib siab tshaj plaws nyob rau hauv ib nrab-lub voj voog, nyob rau hauv parallel nrog lub ncov ntawm LH cov tshuaj hormones thiab estradiol. Nws tseem nyob siab thaum lub sij hawm luteal.

Prolactin thiab cev xeeb tub, tom qab ntawd prolactin thiab kev pub niam mis yog sib txuas. Yog tias qib ib txwm ntawm prolactin tsawg dua 25 ng / ml, nws tuaj yeem nce mus rau 150-200 ng / ml thaum kawg ntawm cev xeeb tub thiab ncov tom qab yug me nyuam. Tseeb, tom qab yug me nyuam thiab tshwj xeeb tshaj yog tom qab yug me nyuam, qib ntawm progesterone tab sis tshwj xeeb tshaj yog cov tshuaj estrogen poob qis, yog li tso prolactin. Cov kua mis ntws tuaj yeem tshwm sim.

Tom qab ntawd, ntau tus me nyuam teats, ntau prolactin thiab oxytocin (qhov tseem ceeb ntawm kev pub niam mis) yog secreted, cov kua mis ntau ntau tau tsim tsis tu ncua. Kwv yees li 15 hnub tom qab yug me nyuam, qib ntawm prolactin pib poob thiab rov qab mus rau qhov qub li 6 lub lis piam tom qab yug me nyuam.

Sib nrug los ntawm kev xeeb tub, qib siab prolactin tuaj yeem yog qhov qhia tau ntawm pathology muaj feem cuam tshuam rau kev xeeb tub: hyperprolactinemia. Ntawm lub hauv paus chiv keeb ntawm qhov tshwm sim: ntau tshaj prolactin hloov qhov tso tawm ntawm GnRH, cov tshuaj tso tawm pituitary gonatrophins, nws tus kheej lub luag haujlwm rau kev tsim cov tshuaj hormones LH (luteinizing hormone) thiab FSH (follicle stimulating hormone ). Txawm li cas los xij, tib cov tshuaj hormones no ua lub luag haujlwm tseem ceeb hauv ovulation. Nov yog qhov peb tau yooj yim paub txog cov tsos mob tseem ceeb ntawm hyperprolactinemia hauv cov poj niam: amenorrhea.

Nws lwm yam cim:

• oligomenorrhea (tsis tshua muaj thiab tsis xwm yeem),
• luv luv luteal theem,
• galactorrhea (mob ntawm mis nyuj),
• ntxiv lawm tshob.

Hyperprolactinemia: txiv neej pathology ib yam nkaus

 Qhov xav tsis thoob, qhov nce qib prolactin kuj tuaj yeem kuaj pom hauv tib neeg. Ntau txoj hauv kev los txheeb xyuas, nws cov tsos mob cuam tshuam nrog qhov loj ntawm cov qog uas twb muaj lawm (mob taub hau, thiab lwm yam). Hyperprolactemia kuj tuaj yeem nrog rau lwm cov cim xws li:

• poob siab,
• erectile kawg,
• gynecomastia (kev loj hlob ntawm cov qog mammary),
• galactorrhee,
• ntxiv lawm tshob.

Yuav piav qhia txog hyperprolactinemia li cas? Hauv feem ntau ntawm cov xwm txheej, iatrogenic ua, piv txwv li cov teebmeem ntawm kev kho mob ua ntej, yog lub luag haujlwm rau qhov txawv txav ntawm prolactin. Cov tshuaj tseem ceeb cuam tshuam yog:

• neuroleptics,
• tricyclic antidepressants,
• metoclopramide thiab domperidone,
• koob tshuaj estrogen (cov tshuaj tiv thaiv kab mob tsis ua rau hyperprolactinemia),
• qee cov tshuaj antihistamines
• qee cov tshuaj antihypertensive,
• tshuaj opioids.

Qhov thib ob feem ntau ua rau hyperprolactinemia: microadenomas, benign qog uas nws loj tsis pub tshaj 10 hli, tsim nyob rau hauv lub caj pas pituitary. Tsis tshua muaj, macroadenomas (loj dua 10 hli hauv qhov loj) yog nrog tsis yog los ntawm kev nce qib prolactin, tab sis kuj los ntawm kev mob taub hau thiab ophthalmologic cov tsos mob ( txwv tsis pub pom kev).

Lwm yam keeb kwm ntawm hyperprolactinemia tuaj yeem nrhiav tau hauv hypothalamic-pituitary ua haujlwm tsis zoo nrog rau cov qog hypothalamic (craniopharyngioma, glioma) lossis kab mob infiltrative (sarcoidosis, X-hystocytosis, thiab lwm yam).

 Thaum kawg, qee qhov pathologies tuaj yeem cuam tshuam txog kev nce qib ntawm prolactin, xws li:

• micropolycystic zes qe menyuam syndrome (PCOS),
• hypothyroidism,
• mob raum tsis ua haujlwm,
• Cushing's syndrome,
• Lwm cov qog los yog qhov txhab ntawm lub hypothalamus.