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神经性厌食症中的闭经及月经复潮的预测因素:一项针对住院患者的心理内分泌学研究

Amenorrhea and predictors for remenorrhea in anorexia nervosa: a psychoendocrinological study in inpatients.

作者信息

Meyer A E, von Holtzapfel B, Deffner G, Engel K, Klick M

出版信息

Psychother Psychosom. 1986;45(3):149-60. doi: 10.1159/000287941.

Abstract

34 consecutively admitted anorexia nervosa inpatients were studied for variables relevant for 'early' vs. 'late' amenorrhea and for probable remenorrhea after therapy. The subsample reporting 'early' amenorrhea, i.e. preceding weight loss (n = 11), was characterized by less 'anorexia-specific' psychological traits and more weight loss before admission and a more marked (= pathological) FSH responsiveness to GnRH stimulation. Hence--contrary to our expectation--'early' amenorrhea seems to be a 'nonpsychogenic' phenomenon. Analysis according to FSH hyperresponsiveness yielded no additional information. Studying LH changes during therapy we found that a nonrise in basal LH secretion is associated with a type of anorexia characterized by early onset and a less severe but protracted course before admission, which then proves also more recalcitrant to therapy. The subsample which attained LH fluctuation before discharge showed a clear reduction of 'weight phobia' and a higher weight both on admission and before discharge.

摘要

对34例连续收治的神经性厌食症住院患者进行了研究,以探讨与“早发性”与“迟发性”闭经相关的变量,以及治疗后可能恢复月经的情况。报告“早发性”闭经(即体重减轻之前)的子样本(n = 11)的特征是“厌食特异性”心理特征较少,入院前体重减轻较多,对促性腺激素释放激素(GnRH)刺激的促卵泡生成素(FSH)反应更明显(即病理性)。因此——与我们的预期相反——“早发性”闭经似乎是一种“非心因性”现象。根据FSH高反应性进行分析未获得更多信息。在研究治疗期间促黄体生成素(LH)的变化时,我们发现基础LH分泌未升高与一种厌食症类型有关,其特征为发病早,入院前病程不严重但持续时间长,随后也证明对治疗更具顽固性。出院前LH出现波动的子样本显示“体重恐惧”明显减轻,入院时和出院前体重均较高。

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