神经性厌食患者的临床表现及内分泌功能改变

通过分析15例神经性厌食患者的临床表现及内分泌功能改变,提出我国神经性厌食的诊断标准。①年龄≤25岁的女性;②多因慢性精神刺激及工作学习紧张过度而发病;③厌食致日进食量<3两及体重减轻20％以上;④伴严重的营养不良及低代谢的临床表现;⑤无其它使体重严重减轻的内科及精神科疾病。患者内分泌功能紊乱主要表现为:①下丘脑功能紊乱,突出地表现为下丘脑—垂体—性腺轴功能低减;②严重营养不良及体重减轻引起的内分泌功能失调。

The Clinical Manifestations and Endocrine Changes of Anorexia Nervosa

We analyzed the clinical manifestations and endocrine changes of 15 cases of anorexia nervosa. One male, aged 42, and 14 females, aged 14-26 were involved in the study. The precipitating causes were chronic psychi-atic trauma (60%), strain (27%) and abnormal fear of being fat (13%). All showed clinical manifestations of hypometabolism and malnutrition. Body weight decreased by 36.3*11.6% on average and 93% of the patients had lost more than 20% of their original weight. All women patients over 16 years old had amenorrhea. The daily intake of grain was less than 150 gm and had decreased by more than 67% as compared with earlier intakes. Although the patients were very thin, 3/4 could maintain ordinary indoor activities.The patients with anorexia nervosa had obvious endocrine disturbances, such as low serum FSH, LH and T3 levels and high basal serum GH and midnight serum cortisol concentrations. The response of TSH to TRH and of FSH and LH to LHRH were delayed, but serum GH and PRL levels rose normally after stimulation. All of these changes are secondary to severe body weight loss or hypofunction of the hypotalamus.