神经性厌食患者内分泌功能的改变

The changes of endocrine function in patients with anorexia nervosa

目的 了解神经性厌食患者内分泌功能的改变及其临床特点。方法 分析 3 0例神经性厌食患者内分泌激素水平的变化及临床资料。结果 (1)本组神经性厌食者均为女性 ,平均年龄 (18.4± 2 .1)岁 ,病程 1～ 6年。临床表现为厌食、严重营养不良和继发性闭经 ;(2 )大多数患者LH、FSH和E2 明显降低 ;8例患者行GnRH刺激时 ,LH、FSH呈延迟反应 ;(3 ) 15例患者甲状腺激素和TSH均正常 ,9例患者表现为单纯性T3 和FT3 减低 ,6例患者甲状腺激素均降低 ;(4 )血、尿皮质醇水平均正常 2 4例 ,增高 6例 ,出现节律紊乱 6例 ;(5 )GH升高 15例 (15 / 16) ,PRL均正常 2 0例(2 0 / 2 0 )。结论 严重营养不良和继发性闭经为神经性厌食患者的主要临床表现 ,伴有多种内分泌功能紊乱 ,继发性闭经是显著体重下降和下丘脑 垂体 性腺轴功能紊乱共同作用的结果。

Objective To observe the changes of endocrinological functions and clinical manifestations in patients with anorexia nervosa (AN).Methods The endocrine functions and clinical features in 30 patients with AN were analyzed. Results Anorexia,serious malnutrition and secondary amenorrhea were the main clinical manifestations.The basic serum LH,FSH and E 2 decreased and the responses of LH,FSH to LHRH stimulation delayed.The investigation discovered 15 patients with normal level of thyroid hormones and TSH,6 patients with decreased level of thyroid hormones.24 patients with normal serum F and UFC level,6 patients with increased serum F and UFC level,respectively.Conclusion AN has multi endocrine disorders, accompanied with the serious malnutrition and secondary amenorrhea.