Shi Y F, Liu Z M
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1989 Jun;11(3):159-64.
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 psychiatric 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 Ts 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 hypothalamus.
我们分析了15例神经性厌食症患者的临床表现和内分泌变化。研究对象包括1名42岁男性和14名14至26岁女性。诱发原因有慢性精神创伤(60%)、压力(27%)和对肥胖的异常恐惧(13%)。所有患者均表现出低代谢和营养不良的临床表现。体重平均下降36.3±11.6%,93%的患者体重减轻超过原体重的20%。所有16岁以上女性患者均闭经。谷物日摄入量少于150克,与之前摄入量相比减少超过67%。尽管患者非常消瘦,但3/4的患者能够维持日常室内活动。神经性厌食症患者存在明显的内分泌紊乱,如血清促卵泡生成素(FSH)、促黄体生成素(LH)和甲状腺素(Ts)水平降低,基础血清生长激素(GH)和午夜血清皮质醇浓度升高。促甲状腺激素(TSH)对促甲状腺激素释放激素(TRH)以及FSH和LH对促黄体生成素释放激素(LHRH)的反应延迟,但刺激后血清GH和催乳素(PRL)水平正常升高。所有这些变化均继发于严重体重减轻或下丘脑功能减退。