·568·生堡塞旦』生塾!堕盎苤查垫!!生!旦笙望鲞笙!塑鱼!垫!垒塑!鱼坚!!!!坐!垒P至!垫!!!!些:望!堕!:!参考文献[1]BemdtT,KumarR.Phosphatoninsandtheregulationofphosphatehomeo—stasis[J].AnnuRevPhysiol,2007,69:341—359.[2]TheresaB,RajivK.Novelmechanismsintheregulationofphosphorushomeostasis[J].Physiology,2008,24:17—25.[3]KumarR.Thephosphatoninsandtheregulationofphosphatehomeostasis[J].Annalesd’Endocrinologie,2006,67:142—146.[4]ShaikhA,BerndtT,KumarR.Regulationofphosphatehomeostasisbythephosphatoninsandothernovelmediators[J].PediatrNephrol,2008,23(8):1203—1210.[5]Kolek01,HinesER,JonesMD,eta1.1alpha,25-DihydroxyvitaminD3upregulatesFGF-23geneexpressioninbone:thefinallinkinarenal—gastrointestinal—skeletalaxisthatcontrolsphosphatetransport[J].AmJPhysiolGastrointestLiverPhysiol,2005,289(6):G1036一G1042.[6]BalX,MiaoD,KaraplisAC,eta1.Transgenicmiceoverexpressinghu—manfibroblastgrowthfactor23(R176Q)delineateaputativeroleforparathyroidhormoneinrenalphosphatewastingdisorders[J].Endocri—nology,2004,145(11):5269—5279.[7]KurosuH,OgawaY,MiyoshiM,eta1.Regulationoffibroblastgrowthfactor-23signalingbyklotho[J].JBiolChem,2006,281(10):6120—6123.[8]LiuS,ZhouJ,TangW,etal.PathogenicroleofFg眩3inDmpl-nullmice[J].AmJPhysiolEndocrinolMetab,2008,295(2):E254一E261.[9]BoskeyAL,ChiangP,FermanisA,eta1.MEPE’Sdiverseeffectsonmi一单纯乳腺早发育梁雁neralizationfJ].CalcifTissueInt,2010,86(1):42—46.[10]BemdtTJ,BieleszB,CraigTA,eta1.Secretedfrizzled-relatedprotein-4reducessodium—phosphatecotransporterabundanceandactivityinpro—ximaltubulecells[J].PflugersArch,2006,451(4):579—587.[11]MarksJ,ChurchillLJ,DebnamES,eta1.Matrixextracellularphospho-glycoproteininhibitsphosphatetransport[J].JAmSocNephrol,2008,19(12):2313—2320.[12]CarpenterTO,EllisBK,InsoqnaKL,eta1.Fibroblastgrowthfactor7:aninhibitorofphosphatetransportderivedfromoncogenicosteomalacia—causingtumors[J].JClinEndocrinolMetab,2005,90(2):1012—1020.[13]ChandranM,ChngCL,ZhaoY,eta1.NovelPHEXgenemutationasso—ciatedwithXlinkedhypophosphatemicrickets[J].NephronPhysiol,2010,116(3):17—21.[14]Levy—LitanV,HershkovitzE,AvizovL,eta1.Autosomal—recessivehy—pophosphatemicricketsisassociatedwithaninactivationmutationintheENPPlgene[J].AmJHumGenet,2010,86(2):273—278.[15]TiosanoD,HochbergZ.Hypophosphatemia:thecommondenominatorofallrickets[J].JBoneMinerMetab,2009,27(4):392—401.[16]CarpenterTO,ImelEA,HolmIA,eta1.AClinician’8guidetoX—linkedhypophosphatemia[J].JBoneMinerRes,2011,26(7):1381—1388.(收稿日期:2013-02-26)(本文编辑:赵金燕)【摘要】单纯乳腺早发育是临床较为常见的一种现象,好发于2岁以下的婴幼儿。患儿除乳腺发育外,不伴有其他性发育的征象。病因及发病机制不明,患儿预后不一,大多自然消退,部分患儿可转为中枢性性早熟。对单纯乳腺早发育的患儿应坚持临床随访,特别是对乳腺持续不消退、进行性增大或消退后复现者;促性腺激素释放激素激发试验LH峰值在3.5~4.5IU/L(免疫化学发光法)时,应注意定期随访,密切观察生长速率、骨龄、第二性征发育情况等。在随访过程中,若出现其他性征发育、生长加速、骨龄超前、性激素水平升高等,则应及时评估和治疗。【关键词】单纯乳腺早发育;不完全性性早熟;中枢性性早熟近年来,儿童性早熟Et益引起人们的关注,“奶粉致女婴性早熟”事件后,单纯乳腺早发育的就诊率亦明显增加。但对此部分患儿在诊断和随访的过程中,需采取不同于中...