Siegel J H, Hardoff D, Golden N H, Shenker I R
Division of Adolescent Medicine, Schneider Children's Hospital of Long Island Jewish Medical Center, New Hyde Park, New York 11042, USA.
J Adolesc Health. 1995 Jun;16(6):448-53. doi: 10.1016/1054-139X(94)00003-W.
Medical information on male anorectics is scant. We present data on 10 males with anorexia nervosa, who were treated at our Eating Disorders Center during a twelve-year period.
Retrospective chart review.
All patients were malnourished weighing 80% or less of their ideal body weight with a mean B.M.I. of 13.5 +/- 2.0. Height below the 50th percentile was evident in 80% of the patients, and was below the 10th percentile in 30% of the patients. Structural brain changes on brain computerized tomography scans were noted in seven out of nine patients and more than 50% had mild anemia relative to the Tanner stage. Other findings included a mean presenting heart rate of 68.3 +/- 17: four out of ten patients had presenting heart rates of 80 or greater and of these, three had serious medical problems and were severely malnourished. Two patients had cardiac complications and one had a life-threatening electrolyte disturbance.
Despite the small number of patients, the proportion of male adolescent anorectics with medical abnormalities seems high, and may be due to difficulties in establishing the diagnosis and delay in seeking medical attention. Patients who had heart rates of 80 or greater were perhaps sicker and further along in their development of congestive heart failure, thus explaining their initial relative tachycardia. We suggest a higher index of suspicion for congestive heart failure and closer medical monitoring when a malnourished adolescent with anorexia nervosa presents with relatively elevated heart rates.
关于男性神经性厌食症患者的医学资料很少。我们提供了在12年期间于我们的饮食失调中心接受治疗的10名男性神经性厌食症患者的数据。
回顾性病历审查。
所有患者均营养不良，体重为理想体重的80%或更低，平均体重指数为13.5±2.0。80%的患者身高低于第50百分位数，30%的患者身高低于第10百分位数。9名患者中有7名在脑部计算机断层扫描中发现有结构性脑改变，超过50%的患者相对于坦纳分期有轻度贫血。其他发现包括平均初始心率为68.3±17：10名患者中有4名初始心率为80次/分钟或更高，其中3名有严重的医学问题且严重营养不良。2名患者有心脏并发症，1名患者有危及生命的电解质紊乱。
尽管患者数量较少，但男性青少年神经性厌食症患者出现医学异常的比例似乎较高，这可能是由于诊断困难和就医延迟所致。初始心率为80次/分钟或更高的患者可能病情更严重，且在充血性心力衰竭的发展过程中更严重，从而解释了他们最初的相对心动过速。我们建议，当一名患有神经性厌食症的营养不良青少年出现相对较高的心率时，应提高对充血性心力衰竭的怀疑指数并加强医疗监测。
