神经性厌食患者甲状腺功能的研究

目的研究神经性厌食患者的甲状腺功能状况,并讨论相应的治疗对策。方法采用微粒子酶联免疫测定法和荧光免疫测定法检测35例神经性厌食(AN)患者和34例正常对照者(NC)的血清T3、T4和TSH水平。结果AN组血清T3和T4水平均显著低于NC组(P<0.01),而两组TSH水平无统计学差异(P>0.05);35例AN患者中,T3降低、T4和TSH均正常的达19例(54.3%),甲状腺功能完全正常的13例(37.1%);AN组T3、T4水平与体质量、BMI、HAMD总分、HAMA总分、YBOCS总分均无显著相关性(P>0.05)。结论AN患者确实存在甲状腺机能紊乱,多数患者为低T3综合征,而非甲状腺机能减退。由于该综合征是可逆的,故通常无需补充甲状腺激素来治疗。

A Study on the Thyroid Function in Patients with Anorexia Nervosa

Objective To study the thyroid function in patients with anorexia nervosa, and discuss the corresponding treatment. Methods Levels of T3, T4 and TSH of 35 patients with anorexia nervosa and 34 normal controls were detected with microparticle enzyme immunoassay and fluorescence polarization immunoassay. Results The levels of both T3 and T4 in patients with anorexia nervosa were significantly lower than those in normal controls (P<0.01); but there was no difference in the levels of TSH between patients and controls(P>0.05). Among the 35 patients with anorexia nervosa, 19 (54.3%) had lower T3, normal T4 and TSH, and 13 (37.1%) had normal thyroid function. There was no correlation between levels of T3,T4 and weight, BMI, total scores of HAMD, HAMA and Y-BOCS, respectively(P>0.05). Conclusion There is abnormal thyroid function in patients with anorexia nervosa. Most of the patients with anorexia nervosa are individuals with low T3 syndrome, rather than hypothyroid. Since this syndrome is reversible, thyroxine is not necessary during the treatment.