He hormone koʻikoʻi no ka holomua maikaʻi o ka hānai ʻana, ua hūnā ʻia ka prolactin i nā koina kiʻekiʻe ma ka hopena o ka hāpai ʻana a i nā pule ma hope o ka hānau ʻana. Ma waho o kēia manawa perinatal, akā naʻe, hiki i nā kiʻekiʻe prolactin kiʻekiʻe ke hoʻopilikia i ka ulu. Nā wehewehe.

ʻO Prolactin kahi hormone hypohyseal. ʻO kāna kuleana: e hoʻomākaukau i ka umauma e hana i ka waiū umauma a hoʻoikaika i ka ulu ʻana o ka mammary glands mai ka wā ʻōpio i nā wahine. I nā kāne ʻelua, loaʻa iā ia nā manaʻo e pili ana i nā cell hypothalamic e hūnā i ka GnRH (hormone e hoʻoulu i ka hana ʻana o nā hormones sex.)

Ua hūnā ʻia i ka wā hāpai a ma waho o ka hāpai ʻana, i ka lā holoʻokoʻa, ʻokoʻa ia ma lalo o ka hopena o kekahi mau kumu:

• kahi meaʻai waiwai i nā protein a i ʻole nā ​​kō,
• hiamoe, - koʻikoʻi (ke kino a noʻonoʻo paha),
• hiki ke anesthesia,
• ke lawe nei i kekahi mau lāʻau.

Hoʻololi pū ka hana ʻana o ka prolactin i ka wā o ka menstrual cycle. No laila, hiki i kona pae kiʻekiʻe ma waena o ka pōʻaiapuni, e like me nā kiʻekiʻe o nā hormones LH a me estradiol. Hoʻokiʻekiʻe ʻia nō hoʻi i ka wā luteal.

ʻO ka prolactin a me ka hāpai ʻana, a laila pili pono ka prolactin a me ka hānai ʻana. Inā emi ka pae maʻamau o ka prolactin ma mua o 25 ng / ml, hiki ke piʻi i 150-200 ng / ml i ka hopena o ka hāpai ʻana a me ka piko ma hope o ka hānau ʻana. ʻOiaʻiʻo, ma hope o ka hānau ʻana a ma hope o ka hānau ʻana, hāʻule nui nā pae o ka progesterone akā ʻoi aku ka nui o ka estrogen, no laila e hoʻokuʻu ana i ka prolactin. Hiki ke kahe ka waiu.

A laila, ʻoi aku ka nui o ka ʻuʻu o ke keiki, ʻoi aku ka nui o ka prolactin a me ka oxytocin (hormone nui o ka hānai ʻana) i hūnā ʻia, ʻoi aku ka nui o ka waiū umauma e hana mau ʻia. Ma kahi o 15 mau lā ma hope o ka hānau ʻana, hoʻomaka ke kiʻekiʻe o ka prolactin e hāʻule a hoʻi i kona pae maʻamau ma kahi o 6 mau pule ma hope o ka hānau ʻana.

Ma waho aʻe o ka hāpai ʻana, hiki i kahi kiʻekiʻe prolactin kiʻekiʻe ke hōʻailona o kahi maʻi maʻi i ka hopena nui i ka momona: hyperprolactinemia. I ke kumu o kēia hanana: hoʻololi ka prolactin keu i ka huna o GnRH, ka hormone hoʻokuʻu i ka pituitary gonatrophins, nona ke kuleana no ka hana ʻana o nā hormones LH (luteinizing hormone) a me FSH (follicle stimulating hormone). Eia nō naʻe, he mea nui kēia mau hormones i ka ovulation. ʻO kēia ke ala maʻalahi mākou e ʻike ai i ka hōʻailona nui o ka hyperprolactinemia i nā wahine: amenorrhea.

ʻO kāna mau hōʻailona ʻē aʻe:

• ʻO ka oligomenorrhea (nā kaʻina hana ʻole a maʻamau),
• kahi manawa luteal pōkole,
• galactorrhea (ka holo o ka waiū),
• ʻaʻohe hānau keiki.

ʻO ka Hyperprolactinemia: kahi maʻi maʻi kāne pū kekahi

 ʻO ka mea kupanaha, hiki ke ʻike ʻia kahi kiʻekiʻe prolactin kiʻekiʻe i ke kanaka. ʻOi aku ka paʻakikī o ka ʻike ʻana, pili kona mau hōʻailona me ka nui o ka maʻi koko (ʻeha poʻo, etc.). Hiki i ka Hyperprolactemia ke hele pū me nā hōʻailona ʻē aʻe e like me:

• nele i ka makemake,
• erectile hana,
• gynecomastia (ka ulu ʻana o nā mammary glands),
• galactorrhée,
• ʻaʻohe hānau keiki.

Pehea e wehewehe ai i ka hyperprolactinemia? I ka hapanui o nā hihia, ʻo nā kumu iatrogenic, ʻo ia hoʻi nā hopena o ka lāʻau lapaʻau mua, ke kuleana no ka piʻi ʻana o ka prolactin. ʻO nā lāʻau lapaʻau nui e pili ana:

• nā neuroleptics,
• nā antidepressants tricyclic,
• metoclopramide a me domperidone,
• ʻO ka estrogen kiʻekiʻe (ʻaʻole i hoʻokumu ʻia ka lāʻau contraceptive i ka hyperprolactinemia),
• kekahi mau antihistamines
• kekahi mau antihypertensive,
• opioids.

ʻO ke kumu maʻamau ʻelua o ka hyperprolactinemia: microadenomas, benign tumors ʻaʻole i ʻoi aku ka nui ma mua o 10 mm, i hana ʻia i loko o ka pituitary gland. ʻO nā macroadenomas (ʻoi aku ka nui ma mua o 10 mm ka nui) i hele pū ʻia ʻaʻole me ka piʻi ʻana o nā pae prolactin wale nō, akā me nā poʻo poʻo a me nā hōʻailona ophthalmologic (palena ʻia o ka ʻike maka).

Hiki ke ʻimi ʻia nā kumu ʻē aʻe o ka hyperprolactinemia ma ka hypothalamic-pituitary dysfunction me kahi maʻi hypothalamic (craniopharyngioma, glioma) a i ʻole kahi maʻi infiltrative (sarcoidosis, X-hystocytosis, etc.).

 ʻO ka mea hope loa, hiki i kekahi mau pathologies ke komo i ka piʻi nui o ke kiʻekiʻe o ka prolactin, e like me:

• ʻO ka maʻi micropolycystic ovary (PCOS),
• hypothyroidism,
• ʻaʻole hiki ke hoʻopaʻa ʻia i ka renal.
• ʻO Cushing's Syndrome,
• nā ʻōpū ʻē aʻe a i ʻole nā ​​​​ʻeha o ka hypothalamus.