珍屯医学

标题: 乳腺增生 [打印本页]

作者: 大江 时间: 2020-3-5 00:06
标题: 乳腺增生
乳腺增生是人乳房的正常或自发性肿胀。乳腺增生通常发生在女性的青春期和妊娠期以及月经周期的某些时期。当它发生在男性中时，称为男性乳房发育症，被认为是病理性的。当它发生在女性中且极度过量时，称为巨乳症（也称为巨乳症或乳房肥大），同样被认为是病理性的。乳腺增生可能是由于乳房充血，这是由于哺乳和/或溢乳（过多或不合适的乳汁分泌）导致母乳的生产和储存引起的乳房暂时性肿大。乳腺增生常伴有乳房痛（乳房压痛/疼痛）。

在月经周期的黄体期（后半期），由于高浓度的雌激素和/或孕激素导致乳房血流量增加和/或经前体液潴留，乳房暂时增大，这是女性所经历的饱满，沉重，肿胀和刺痛感。

乳腺增生可以是多种药物的作用或副作用，包括雌激素，抗雄激素（例如螺内酯，醋酸环丙孕酮，比卡鲁胺和非那雄胺），生长激素，以及可提高催乳素水平的药物，例如D2受体拮抗剂，如抗精神病药（例如利培酮），胃复安和多潘立酮，以及某些抗抑郁药，例如选择性5-羟色胺再摄取抑制剂（SSRIs）和三环抗抑郁药（TCA）。使用5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）（如文拉法辛）的风险似乎更低。 “非典型”抗抑郁药米氮平和安非他酮不会增加催乳素水平（安非他酮实际上可能会降低催乳素水平），因此这些药物可能没有风险。与乳腺增生有关的其他药物包括D-青霉胺，布西拉明，新塞他酮，环孢菌素，茚地那韦，大麻和西咪替丁。

1997年的一项研究发现，在59名女性参与者中，有23名（39％）的SSRI与乳腺增生之间存在关联。研究还发现SSRI与溢乳之间存在关联。这些副作用似乎是由于这些药物引起的高催乳素血症（催乳素水平升高）引起的，这种作用似乎是由5-羟色胺介导的抑制泌乳素的多巴胺能神经元抑制催乳素分泌引起的。已发现这些药物可能导致的乳腺增生与体重增加高度相关（在1997年的研究中，有83％体重增加的人也经历了乳腺增生，而只有30％没有体重增加的人经历了乳腺增生。乳腺增生）。据报道，与SSRIs相关的乳腺增生可通过停药而逆转。 SSRIs与乳腺癌风险适度增加有关。这与催乳素水平升高与乳腺癌风险增加有关。

在性腺机能减退女孩的青春期诱导和变性女性的女性化激素治疗中，以及在乳腺增生或小乳房的女性中荷尔蒙的丰胸，乳腺增生是一种理想的效果。

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