青春期发育延迟的鉴别诊断进展  

Update of differential diagnosis for delayed puberty

作　　者：蔡芸莹[1] 苏恒[1] Cai Yunying;Su Heng(Department of Endocrinology,the First People's Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650032,China)

机构地区：[1]云南省第一人民医院内分泌科,昆明理工大学附属医院,昆明650032

出　　处：《国际内分泌代谢杂志》2023年第6期477-480,共4页International Journal of Endocrinology and Metabolism

基　　金：云南省卫生和计划生育委员会医学人才培养项目(L-201624);云南省万人计划"名医"专项(YNWR-MY-2019-020)。

摘　　要：体质性青春期发育延迟(constitutional delay of growth and puberty,CDGP)与先天性低促性腺激素性性腺功能减退(congenital hypogonadotropic hypogonadism,CHH)是两类导致青春期发育延迟的常见病因。两者在临床表现上具有较高的相似性,均表现为缺乏正常青春期启动、血液循环中促性腺激素及性激素水平低下。尽管CDGP为一过性、自限性的青春期发育延迟,而CHH是持久性的性腺功能减退,但两者在成年期前较难准确鉴别。近年来的研究显示,微小青春期对于早期诊断CHH是一个非常重要的时间窗口。此外,抑制素B水平以及Kisspeptin兴奋试验可能在两者的鉴别诊断上具有较大的应用价值。Constitutional delay of growth and puberty(CDGP)and congenital hypogonadotropic Hypogonadism(CHH)are two common causes of delayed puberty.There is a high similarity between them in clinical manifestations:lack of normal puberty initiation,low levels of gonadotropin,and sex hormone.Although CDGP is a transient,self-limited form of delayed puberty while CHH is permanent,it isn't easy to accurately distinguish the two before adulthood.Recent studies have shown that mini-puberty is a critical time window for the early diagnosis of CHH.In addition,the inhibin B level and Kisspeptin stimulation test may have great application value in the differential diagnosis of the two.

关 键 词：先天性低促性腺激素性性腺功能减退 体质性青春期发育延迟 抑制素B 动态试验 

分 类 号：R588[医药卫生—内分泌]