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　　(一)熱量一蛋白質(zhì)攝入不足</p><p> 　　正常情況下，進(jìn)食是攝人能量的唯一方式。營養(yǎng)饋乏而消瘦者多由于熱量一蛋白質(zhì)營養(yǎng)不足引起。熱量攝人不足時，首先由脂肪組織提供能量，蛋白質(zhì)提供氨基酸作為糖原異生的底物。如災(zāi)荒、戰(zhàn)爭和生產(chǎn)落后的貧困地區(qū)，以熱量不足者稱為消耗癥(Marimus),人表現(xiàn)極明顯消瘦，無水腫;以蛋白質(zhì)攝人不足者稱為Kwshior-kor病，常有水腫。</p><p> 　　(二)下丘腦綜合征</p><p> 　　多種因素致下丘腦損傷，腹外側(cè)核食餌中樞(嗜食中樞)損害，則腹內(nèi)側(cè)核飽覺中樞(厭食中樞)相對興奮而拒食、厭食，導(dǎo)致消瘦。(三)口腔、咽、喉、食管、賁門病變致咽下困難，影響進(jìn)食而致消瘦</p><p> 　　1.口腔炎癥、潰瘍、損傷：如核黃素缺乏、白塞病所致口腔潰瘍、炎癥，煙酸胺缺乏所致舌炎，牙及牙齦病變。</p><p> 　　2.咽、喉部炎癥、結(jié)核、癌腫。</p><p> 　　3.食管炎癥或狹窄、食管賁門癌腫、責(zé)門失弛緩癥或狹窄。</p><p> 　　4.腦神經(jīng)麻痹、球麻痹。</p><p> 　　5.重癥肌無力、多發(fā)性肌炎、系統(tǒng)性硬化癥等致食管肌肉損傷。</p><p> 　　(四)胃腸疾病</p><p> 　　如慢性胃炎、消化性潰瘍、胃癌、幽門狹窄。不完全性腸梗阻、胃大部切除術(shù)后等，常使?fàn)I養(yǎng)物攝人不足而致消瘦。</p><p> 　　(五)惡性腫瘤</p><p> 　　消瘦常為惡性腫瘤的主要表現(xiàn)之一。引起消瘦的原因可能為：①食欲缺乏是主要因素，尤其因焦慮和治療反應(yīng)等，加重了食欲缺乏。②腫瘤的迅速生長消耗能量;③惡性腫瘤可能產(chǎn)生一種代謝毒素，使患者葡萄糖利用率降低，游離脂肪酸的氧化代謝增加，使氨基酸和乳酸鹽向糖原異生增加，ATP的無效消耗增多。④腫瘤繼發(fā)感染、出血、滲出等使中晚期惡性腫瘤患者更加消瘦。</p><p> 　　(六)慢性感染</p><p> 　　如結(jié)核病、血吸蟲病、傷寒、慢性化膿性感染等致患者明顯食欲缺乏，發(fā)熱增加了能量消耗。艾滋病患者首發(fā)癥狀是消瘦、乏力、發(fā)熱。(七)重要臟器慢性病變或功能衰竭引起消瘦</p><p> 　　如心臟功能衰竭致肝臟及胃腸道充血、水腫，慢性肺心疾患致組織缺血、缺氧、嚴(yán)重肝病如肝硬化門脈高壓所致的胃腸道淤血水腫，肝功能損傷所致的腹脹、惡心、甚至嘔吐、低蛋白血癥，腎衰竭尿毒癥所致的惡心、嘔吐、食欲缺乏等，以上均因食欲缺乏影響了營養(yǎng)物質(zhì)攝入導(dǎo)致消瘦。</p><p> 　　(八)某些藥物的使用常致食欲缺乏而消瘦</p><p> 　　如長期使用各種抗生素、磺胺藥治療各種感染性疾病時，長期應(yīng)用氨茶堿、對氨水楊酸。氯化胺、雌激素等可致上腹部脹滿、食欲減退，甲狀腺素、苯丙胺等可使代謝率明顯增加，長期應(yīng)用瀉藥影響腸道吸收功能可致消瘦。</p><p> 　　(九)精神性厭食</p><p> 　　患者由于情緒紊亂處于拒食狀態(tài)，體重可急劇下降。</p><p> 　　導(dǎo)致瘦的原因二、營養(yǎng)物質(zhì)丟失增加</p><p> 　　1.慢性炎癥性腸病所致的腹瀉大量營養(yǎng)物質(zhì)從消化道排出而致消瘦，如慢性腸炎、慢性菌痢、潰瘍性結(jié)腸炎、腸結(jié)核地Crohn病等。</p><p> 　　2.小腸大部切除術(shù)后、腸疾、盲樓綜合征小腸是食物消化和吸收的主要場所，小腸病變致營養(yǎng)物質(zhì)吸收障礙而消瘦。</p><p> 　　3.肝膽及胰腺系統(tǒng)疾病由于胰腺外分泌和膽汁分泌不足或缺乏，使食物消化吸收障礙。</p><p> 　　4.糖尿病因大量葡萄測尿中排出而消瘦。慢性腎炎患者大量蛋白尿時致低蛋白血癥，其消瘦常被水腫掩蓋。大面積燒傷、剝脫性皮炎時皮膚大面積糜爛，創(chuàng)面有大量血漿滲出，致能量損失。</p><p> 　　導(dǎo)致瘦的原因三、代謝率增高致消耗增加</p><p> 　　甲狀腺功能亢進(jìn)癥或服用甲狀腺素過量，嗜鉻細(xì)胞瘤時大量兒茶酚胺釋放人血循環(huán)，均使代謝率增加，三大營養(yǎng)物質(zhì)分解氧化代謝增加，雖有多食，仍使體重明顯減輕。類癌綜合征患者的消瘦除因腹瀉和吸收不良外，代謝率增高也是因素之一。</p><p> 　　其他還有長期發(fā)熱、運動過量、長期失眠等可因能量消耗過度而消瘦。</p> </div> <div id="tmyyfroktkho" class="y_ju"><script type="text/javascript">a("conten");</script></div> <div id="tmyyfroktkho" class="pnum"> <ul id="page_slice"> <div id="tmyyfroktkho" class="clear"></div> </ul> </div> </article> <div id="tmyyfroktkho" class="list_hot ar_related bj_mt20 louti"> <h4 class="title2 title2_te">相關(guān)文章</h4> <ul class="bj_mt20"> <li id="tmyyfroktkho" class="lb_3 chao"> <time>02-16</time> <a href="http://www.rzpgrj.com/jiyili/rumen/63447.html" title="記憶力下降的原因" target="_blank">記憶力下降的原因</a> </li> <li id="tmyyfroktkho" class="lb_3 chao"> <time>02-16</time> <a href="http://www.rzpgrj.com/jiyili/rumen/63439.html" title="孩子記憶力差的原因？如何提高孩子記憶力？" target="_blank">孩子記憶力差的原因？如何提高孩子記憶力？</a> </li> <li id="tmyyfroktkho" class="lb_3 chao"> <time>02-16</time> <a 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