| Objective: To investigate the different clinical measures (surgery, drugs) on the treatment of the microprolactinomas efficacy,seeking ralated factors of efficacy and prognostic,to guide clinical treatment.Methods:From 2002 to 2008 years, in the neurosurgery department of fourth affiliated hospital of Suzhou University and neurosurgery department of the affiliated hospital of Weifang Medical College,102 cases who suffered from microprolactinoma were retrospectively analyzed. All objects were divided into 2 therapeutic groups (surgery group,BRC group).According to the age,course,basal prolactine level and tumor size,the patients were subdivided into 3 age groups,3 course groups,3 PRL level groups and two tumor size groups. Comparisons of the effects of surgery,bromocriptine and gamma knife on microprolactinomas were performed within different subgroups.Results: All patients were females ,aged from 15 to 51 years, with an mean age of 30.83±9.64.The course was from 2 to 70 months with an mean 33.89±19.66, and PRL levels of blood before treatment was 102-481 ug / l with an mean 184.20±123.90ug / l.PRL levels of blood after treatment is 4-155 ug / l, with mean 24.20±27.95 ug / l. Restoring normal blood PRL was for 69 cases (67 %,drug group 47 cases and surgery group 22 cases), the resumption of normal menstrual was 78 cases (76.4%,54 cases of drug group and 24 surgical cases), lactation disappeared in 80 cases (78%,54 cases in surgical group,and 26 cases in drug group). In surgery group,plasma PRL level of 33 cases in different subgroup according to different factors were statisticly different(P<0.05). Univariate regress analysis between different factors and therapeuti effecs with transsphenoidal microsurgery found that tumor size,pretherapy plasma PRL level may be the influencing factors of therapeutic effects with transsphenoidal microsurgery;In logistic regression analysis,it found that only pretherapy plasma PRL level was the independent influencing factor of post-treatment plasma PRL level,only post-treatment plasma PRL level is the independent influencing factor of menstruation normal-restored and laction disappearing.In drug group,plasma PRL level of 69 cases in different subgroup according to different factors were statisticly different(P<0.05). Univariate regress analysis between different factors and therapeuti effects with transsphenoidal microsurgery found that age,tumor size,pretherapy plasma PRL level may be the influencing factors of therapeutic effects with transsphenoidal microsurgery;In logistic regression analysis,it found that only pretherapy plasma PRL level was the independent influencing factor of post-treatment plasma PRL level,only post-treatment plasma PRL level is the independent influencing factor of menstruation normal-restored and laction disappearing.Conclusions: 1.Transsphenoidal surgery and drug(Bromcriptine) applications are effective treatment means for pituitary microprolactinamas. 2.Bromocriptine treatment should be given to treat microprolactinamas at first. A serious drug side effects, unsatisfactory treatment results, reluctant long-term medication, no reproductive requirements of the patient should be given the transsphenoidal surgery, and it can achieve better clinical efficacy. At the same time we stressed the need for standardization and integration of the individual. 3.Pre-therapy plasma PRL levels is the independent factors affecting post-treatment plasma PRL level. Post-treatment plasma PRL level is the independent influencing factor of menstruation normal-restored and laction disappearing.Therefore, the pre-treatment plasma PRL levels can forecast post-treatment plasma PRL level. 4.Drug therapy can achieve the desire therapeutic effect for the patients whose plasma PRL level below 200μg/l. Untolerance for drugs or poor compliance of the patients can be given surgical treatment;The patients'treatment results whose plasma PRL level≥200μg/l is poor than the <200μg/l patients in the effects of drugs and surgical treatment.
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