神经性厌食症引起闭经的女性内分泌临床探讨

A Clinical Analysis on Cases of Secondary Amenorrhea Inducecd by Anorexia Nervosa

目的探讨对神经性厌食症引起闭经患者的临床特点,女性内分泌水平的改变及治疗方法,提高对这类患者的临床认识。方法对32例神经性厌食症引起闭经患者的临床资料、女性内分泌激素水平及相关指标的改变和治疗效果进行回顾性分析和随访。结果本病常见诱因为心理压力大和过分降体重;显著体重下降和闭经是神经性厌食症的主要临床特征。经过综合治疗后,大多数患者体重增加,一般状况改善,部分患者月经恢复正常,但人工周期治疗组与未接受人工周期治疗组之间无明显差异。结论神经性厌食症导致继发性闭经是由于下丘脑-垂体功能紊乱及体重减轻的共同作用引起的,其中体重减轻是重要诱因,体重恢复是月经恢复正常的重要条件。在治疗过程中,人工周期治疗仅为综合辅助治疗的一种手段,可根据体重恢复情况和卵巢功能情况来选择使用。

Objective：To analyze the clinical characteristics of secondary amenorrhea induced by anorexia nervosa,the changes of female hormone and treatment methods,and to improve the diagnosis and treatment. Methods：The clinical materials,level of female hermone,the changes of and treament methods of 32 cases of secondary amenorrhea induced by anorexia nervosa were retrospective analysed and followed up. Result：The patients in the group were all females and the common causes were psychic stressand the desire of slimming. The clinical symtoms were mainly dislike for food, thinning and secondary amenorrhea. Andtreatments were effective in the absolute majority of the patients, but hormone replacement therapy was not effective in groups. Conclusion：The disorder of hypothalamus-pituitary gland and the lose of weight are closely related to the oecurrrence of secondary amenorrhea induced by anorexia nervosa, and the weight-lose is more important. Comprehensive method should be applied including psychology,medicine and nutrition. Hormone replacement therapy is not necessary,and should be uesed according to the convalescence of ovarian function and weight.