Gwirtsman H E, Kaye W H, George D T, Carosella N W, Greene R C, Jimerson D C
University of California, Los Angeles School of Medicine, Neuropsychiatric Institute 90024.
J Clin Psychiatry. 1989 Jun;50(6):196-204.
Hyperamylasemia and parotid hypertrophy are conditions found in bulimic patients. The authors studied serum amylase levels in 56 underweight anorectics, 24 weight-recovered anorectics, 23 normal-weight bulimics, and 31 volunteer women. Normal-weight bulimic patients had significantly higher admission serum amylase values (mean +/- SE = 73.4 +/- 8.0 IU/L) than controls (40.8 +/- 2.4 IU/L). Additionally, the serum amylase test distinguished between restrictor anorectics (N = 31, 44.7 +/- 4.7 IU/L) and bulimic anorectics (N = 25, 68.8 +/- 8.6 IU/L, p less than .05) with a high degree of specificity and a fair degree of sensitivity. A subsample (N = 7) of bulimics showed twofold to fourfold increases in serum amylase values after a controlled period of binge eating and vomiting, whereas normal volunteers showed no change in serum amylase values (p less than .001) after ingesting a large meal. Serum amylase values declined significantly within 6 to 15 days of admission. However, after passes off the unit, serum amylase values returned to admission values, presumably as a result of binge-vomit episodes. The authors observe that modest increases of serum amylase values appear to be a consequence of binge-vomit behavior and suggest that serial serum amylase determination may be useful in monitoring the degree of patient abstinence in therapeutic programs.
高淀粉酶血症和腮腺肥大是在贪食症患者中发现的病症。作者研究了56名体重过轻的厌食症患者、24名体重恢复的厌食症患者、23名体重正常的贪食症患者和31名志愿者女性的血清淀粉酶水平。体重正常的贪食症患者入院时的血清淀粉酶值（均值±标准误=73.4±8.0 IU/L）显著高于对照组（40.8±2.4 IU/L）。此外，血清淀粉酶检测以高度的特异性和一定程度的敏感性区分了限制型厌食症患者（N = 31，44.7±4.7 IU/L）和贪食型厌食症患者（N = 25，68.8±8.6 IU/L，p<0.05）。一组贪食症患者的子样本（N = 7）在一段可控的暴饮暴食和呕吐期后血清淀粉酶值增加了两倍至四倍，而正常志愿者在摄入大量食物后血清淀粉酶值没有变化（p<0.001）。血清淀粉酶值在入院后6至15天内显著下降。然而，出院后，血清淀粉酶值又恢复到入院时的水平，推测是由于暴饮暴食-呕吐发作所致。作者观察到血清淀粉酶值的适度升高似乎是暴饮暴食-呕吐行为的结果，并建议连续测定血清淀粉酶可能有助于监测治疗项目中患者的节制程度。
