Rey Rodolfo
Centro de Investigaciones Endocrinológicas, Consejo Nacional de Investigaciones Científicas y Técnicas, Hospital de Niños R. Gutiérrez, Buenos Aires, Argentina.
J Pediatr Endocrinol Metab. 2003 Mar;16(3):357-64. doi: 10.1515/jpem.2003.16.3.357.
In normal clinical practice, testicular evaluation in boys has relied on palpation and testosterone determination after hCG stimulation, which reflects the activity of interstitial Leydig cells. However, the most active compartment of the testis before puberty is the seminiferous tubule compartment, in which Sertoli cells proliferate and secrete anti-Müllerian hormone (AMH) and inhibin B. The recent development of commercially available assays for these two peptides has provided the pediatrician with excellent tools to assess the existence of functional testicular tissue in boys with no need for hCG stimulation. Serum AMH determination is also useful to assess testicular tissue mass and function in patients with intersex disorders. The determination of testosterone, its precursors and dihydrotestosterone, after hCG stimulation, should be reserved for situations in which Leydig cell function needs to be specifically assessed.
在正常临床实践中，男孩的睾丸评估一直依赖于触诊以及人绒毛膜促性腺激素（hCG）刺激后的睾酮测定，这反映了睾丸间质细胞的活性。然而，青春期前睾丸最活跃的部分是生精小管部分，其中支持细胞增殖并分泌抗苗勒管激素（AMH）和抑制素B。最近针对这两种肽的商业可用检测方法的开发，为儿科医生提供了无需hCG刺激即可评估男孩功能性睾丸组织是否存在的优良工具。血清AMH测定对于评估两性畸形患者的睾丸组织质量和功能也很有用。hCG刺激后睾酮、其前体和双氢睾酮的测定，应保留用于需要专门评估睾丸间质细胞功能的情况。
