严重神经性厌食症：医疗稳定单元的治疗结果。

Severe anorexia nervosa: outcomes from a medical stabilization unit.

机构信息

University of Colorado Denver, Denver, Colorado, USA.

出版信息

Int J Eat Disord. 2012 Jan;45(1):85-92. doi: 10.1002/eat.20889. Epub 2010 Dec 10.

DOI:10.1002/eat.20889

PMID:22170021

Abstract

OBJECTIVE

We report data from the medical stabilization and refeeding of patients with severe anorexia nervosa admitted over a 15-month period.

METHOD

Through chart review and computerized data collection, we evaluated demographic and clinical data from 25 consecutive patients admitted to our medical stabilization unit from October 2008 to January 2010.

RESULTS

In this adult-patient population with a median body mass index (BMI) of 13.1 kg/m(2) (interquartile range, 11.0-14.4), 44% developed hypoglycemia, 76% had abnormal liver function, 83% had abnormal bone density, 45% developed refeeding hypophosphatemia, and 92% were hypothermic. Severe liver function abnormality predicted the development of hypoglycemia (p = 0.02, OR 9.78, CI: 1.55-61.65). No clinical features predicted hypophosphatemia, including admission BMI (p = 0.19), serum glucose level (p = 0.21), elevated liver function tests (p = 0.39 for AST), or initial amount of kilocalories consumed (p = 0.06).

DISCUSSION

Patients with the most severe cases of anorexia nervosa have a high prevalence of serious medical complications during initial refeeding.

摘要

目的

我们报告了在 15 个月的时间内对患有严重神经性厌食症的患者进行医学稳定和再喂养的数据。

方法

通过图表回顾和计算机数据收集，我们评估了 2008 年 10 月至 2010 年 1 月期间连续 25 名入住我们医学稳定病房的患者的人口统计学和临床数据。

结果

在这个成年患者群体中，中位数体重指数（BMI）为 13.1kg/m²（四分位距，11.0-14.4），44%的患者发生低血糖，76%的患者肝功能异常，83%的患者骨密度异常，45%的患者出现再喂养性低磷血症，92%的患者体温过低。严重肝功能异常预测低血糖的发生（p = 0.02，OR 9.78，CI：1.55-61.65）。没有临床特征可以预测低磷血症，包括入院 BMI（p = 0.19）、血清葡萄糖水平（p = 0.21）、肝酶升高（AST 升高时 p = 0.39）或初始卡路里摄入量（p = 0.06）。