Sobanski E, Hiltmann W D, Blanz B, Klein M, Schmidt M H
Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Mannheim.
Eur Child Adolesc Psychiatry. 1997 Dec;6(4):207-11. doi: 10.1007/BF00539927.
In sixteen adolescent anorectic inpatients with secondary amenorrhea pelvic ultrasound examination of the ovaries was performed at lowest weight and after weight recovery. The outcome was assessed six months later at follow-up, assigning the patients to the categories of good, intermediate and poor outcome according to the modified Morgan and Russell criteria. At lowest weight all patients' ovaries were smaller than expected for age. After weight recovery the good outcome group had mature and fully developed ovaries whereas the ovarian morphology of patients with poor outcome remained prepubertal. The ovarian volume in the good outcome group was significantly higher than in the poor outcome group. From a threshold BMI of 17.8 upwards we observed a positive linear correlation between BMI and ovarian volume. At BMI 18 the probability for recovered ovaries was 53% rising to 82% at BMI 19.8, which was the highest noting in our study. Nevertheless, we could not find a clear cut-off BMI for definite prediction of recovered ovaries. Therefore, in patients with anorexia nervosa pelvic ultrasound is a very suitable method for determining the target weight required for recovery of ovarian function and resumption of menses. Normalized ovaries indicate favourable outcome and physical recovery.
对16例患有继发性闭经的青春期厌食症住院患者，在其体重最低时及体重恢复后进行了卵巢的盆腔超声检查。6个月后的随访时评估结果，根据改良的摩根和拉塞尔标准将患者分为预后良好、中等和不良三类。在体重最低时，所有患者的卵巢均小于预期年龄。体重恢复后，预后良好组的卵巢成熟且发育完全，而预后不良组患者的卵巢形态仍处于青春期前。预后良好组的卵巢体积显著高于预后不良组。从BMI阈值17.8开始，我们观察到BMI与卵巢体积呈正线性相关。BMI为18时，卵巢恢复的概率为53%，BMI为19.8时升至82%，这是我们研究中观察到的最高值。然而，我们未能找到明确的BMI临界值来确切预测卵巢恢复情况。因此，对于神经性厌食症患者，盆腔超声是确定恢复卵巢功能和月经复潮所需目标体重的非常合适的方法。卵巢恢复正常表明预后良好和身体恢复。
