摘要
目的探讨高泌乳素血症妇女免疫功能状态及下丘脑-垂体-肾上腺(H-P-A)轴功能的改变。方法检测高泌乳素血症妇女34例(病例组)和健康育龄妇女20例(对照组)外周血CD4+T、CD8+T淋巴细胞、抗心磷脂抗体和白细胞介素-2(IL-2)水平,皮质醇(Cs)和肾上腺皮质激素释放激素(ACTH)水平。结果(1)外周血CD4+T病例组为(42.17±6.28)%,明显低于对照组的(47.07±4.98)%(P<0.01);CD4+T/CD8+T比值病例组为(1.81±0.47),明显低于对照组(2.07±0.39)(P<0.05)。(2)抗心磷脂抗体IgG阳性率病例组(32.35%)明显高于对照组(5%)(P<0.05)。(3)IL-2水平病例组为(145.33±100)nmol/L,与对照组(89.33±40.67)mmol/L比较显著升高(P<0.05)。(4)8AM和4PM的Cs水平病例组分别为(588.61±226.61)、(348.53±179.02)nmol/L,ACTH分别为(6.31±1.85)、(6.28±3.27)pmol/L。其中病例组8AM的ACTH水平降低,4PM的ACTH、Cs水平升高,与对照组分别为(7.28±0.75)、(3.85±0.57)pmol/L,(261.70±64.11)nmol/L比较,均有显著性差异(P<0.01,P<0.05,P<0.01);病例组ACTH分泌峰值不明显,节律异常。(5)对照组IL-2与ACTH(8AM、4PM)水平均呈正相关(r=0.609,P=0.004;r=0.499,P=0.047);病例组降低的ACTH(8AM)与升高的泌乳素(PRL)水平呈负相关(r=-0.393,P=0.022)。结论高泌乳素血症患者机体内存在免疫系统机能异常状态,其H-P-A轴中Cs、ACTH分泌水平及节律紊乱。PRL可能对内分泌激素、细胞因子及神经递质发挥多重作用。
Objective： To investigate the immune function and the function of hypothalamic-pituitary-adrenal （H-P-A） axis in the condition of hyperprolactinemia. Methods： The levels of CD4^＋ T, CD8^＋ T, interleukin （IL）-2, cortisol, adrenocorticotropin and the anticardiolipin antibody were measured in thirty-four hyperprolactinemic women. Twenty normal fertile women were taken as control. Results： （1） The percentage of CD4^＋T lymphocyte cell was significantly （P〈0.01） reduced in hyperprolactinemic women [（42.17 ±6.28）%] than that in control group [（47.07 ± 4.98）%]. The ratio of CD4^＋ T/CD8^＋T in hyperprolactinemic women （1.81±0.47） was significantly （P〈0. 05） lower than control group （2.07±0.39）. （2） The positive rate of anticardiolipin antibody （IgG） in hyperprolactinemic women （32.35%） was significantly （P〈0.05）higher than that of control group （5%）. （3） Serum level of IL-2 was significantly （P〈0.05） higher in hyperprolactinemic women [（2.18±1.5）ng/ml] than that in control group [（1.34 ± 0. 61） ng/ml]. （4） In hyperprolactinemic women, the levels of cortisol （8 ： 00AM and 4PM） were （588. 16±226.61 and 348. 53±179.02）nmol/ml and the levels of ACTH （8：00AM and 4PM） were （28. 70±8. 93,28.53±14.86）pg/ml. There were significantly higher cortisol and ACTH levels at 4：00PM （P〈0.05 and P〈0.01, respectively） and lower ACTH level at 8：00AM （P〈0. 01） compared to controls [（261.70±64.11） nmol/ml, （17.49±2.60） pg/ml and （33. 70±3.40） pg/ml, respectively]. The abnormal diurnal rhythm of cortisol and ACTH secretion was observed. There was no normal ACTH peak phase at 8：00AM. （5） The levels of IL-2 in control correlated positively with the levels of ACTH both at 8：00AM and 4：00PM. In hyperprolactinemic women, the lower level of ACTH （8：00AM） correlated negatively with the higher level of prolactin. Conclusions： The immune system is abnormal in the women with hyperprolactinemia, and the levels and diurnal rhythm of cortisol and ACTH in H-P-A axis are disturbed. Prolactin may play various roles such as a cytokine, an endocrine hormone and a neurotransmitter in the regulation of network balance.
出处
《生殖医学杂志》
CAS
2006年第2期84-87,共4页
Journal of Reproductive Medicine
