综合报道

去氨加压素对单症状遗尿症患儿症状及睡眠质量影响

  • 吕磊 ,
  • 王一鹤 ,
  • 胡绘杰 ,
  • 赵莹 ,
  • 刘二鹏 ,
  • 张艳平 ,
  • 蒲青崧 ,
  • 杨兴欢 ,
  • 汲凤平 ,
  • 文建国
展开
  • 1. 郑州大学第一附属医院 河南省小儿尿动力国际联合实验室(河南郑州 450052)
    2. 新乡医学院三全学院(河南新乡 453513)
    3. 新乡医学院护理学院(河南新乡 453004)

收稿日期: 2021-08-30

  网络出版日期: 2022-04-07

基金资助

国家自然科学基金No(81670689);国家自然科学基金No(U1904208);河南省科技厅国际合作重点项目(182102410002)

Effects of desmopressin on symptoms and sleep quality in children with monosymptomatic nocturnal enuresis

  • Lei LYU ,
  • Yihe WANG ,
  • Huijie HU ,
  • Ying ZHAO ,
  • Erpeng LIU ,
  • Yanping ZHANG ,
  • Qingsong PU ,
  • Xinghuan YANG ,
  • Fengping JI ,
  • Jianguo WEN
Expand
  • 1. Henan Joint International Paediatric Urodynamic Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
    2. Sanquan College, Xinxiang Medical College, Xinxiang 453513, Henan, China
    3. School of Nursing, Xinxiang Medical College, Xinxiang 453004, Henan, China

Received date: 2021-08-30

  Online published: 2022-04-07

摘要

目的 探讨去氨加压素(DDAVP)治疗单症状遗尿症(MNE)患儿症状和睡眠改善情况。 方法 选择2018—2020年门诊就诊的69例MNE患儿进行为期12周的DDAVP治疗随访研究,12周后根据遗尿改善情况将患儿分为治疗改善组和无改善组,分析DDAVP治疗对遗尿症状和睡眠质量的影响。 结果 基线入组的69例MNE患儿中,7例中途退出随访,最终纳入62例,男34例、女28例,平均年龄(8.77±1.94)岁。接受DDAVP治疗的MNE患儿,基线、第4周、第8周、第12周的遗尿夜晚数、儿童睡眠习惯问卷(CSHQ)总分、遗尿发生时间、平时及周末睡眠时间差异均有统计学意义(P<0.05),第12周遗尿夜晚数和CSHQ总分较基线值明显下降,遗尿发生时间、平时及周末睡眠时间较基线值明显延长,差异均有统计学意义(P<0.05)。与无改善组(n=22)相比,第8周、第12周改善组(n=40)的CSHQ总分较低,遗尿发生时间、平时和周末睡眠时间均明显延长,每周遗尿夜晚数减少,差异有统计学意义(P<0.05)。从CSHQ评分8个层面得分来看,改善组在就寝习惯、入睡潜伏期、睡眠持续时间、睡眠焦虑、夜醒、异态睡眠及白天嗜睡层面的得分差异均有统计学意义(P<0.05),无改善组仅在睡眠持续时间层面的差异有统计学意义(P<0.05)。 结论 DDAVP治疗12周可明显改善MNE患儿的症状并提高其睡眠质量。

本文引用格式

吕磊 , 王一鹤 , 胡绘杰 , 赵莹 , 刘二鹏 , 张艳平 , 蒲青崧 , 杨兴欢 , 汲凤平 , 文建国 . 去氨加压素对单症状遗尿症患儿症状及睡眠质量影响[J]. 临床儿科杂志, 2022 , 40(4) : 294 -299 . DOI: 10.12372/jcp.2022.21e1237

Abstract

Objectives To investigate the improvement of symptoms and sleep in children with monosymptomatic nocturnal enuresis (MNE) treated with desmopressin (DDAVP). Methods A total of 69 children with MNE who were treated in our clinic from 2018 to 2020 were selected for a 12-week follow-up study of DDAVP treatment. After 12 weeks, the children were divided into improvement group and non-improvement group according to the remission of enuresis, and the effect of DDAVP treatment on enuresis symptoms and sleep quality was analyzed. Results Among the 69 children with MNE enrolled at baseline, 7 dropped out of the follow-up, and 62 were eventually included, including 34 boys and 28 girls, with an average age of (8.77±1.94) years. In all MNE children treated with DDAVP, there were statistically significant differences in the number of enuresis nights, total score of the children's sleep habits questionnaire (CSHQ), occurrence time of enuresis, and sleep time on weekdays and weekends between baseline, weeks 4, 8 and 12 (P<0.05). Compared with baseline, the number of enuresis nights and the total score of CSHQ at week 12 were significantly decreased, and the occurrence time of enuresis and sleep time on weekdays and weekends were significantly prolonged, and the differences were statistically significant (P<0.05). Compared with the non-improvement group (n=22), the improvement group (n=40) at week 8 and 12 had lower CSHQ scores, significantly longer enuresis occurrence time, sleep time on weekdays and weekends, and fewer enuresis nights per week, and the differences were statistically significant (P<0.05). In terms of CSHQ scores at 8 levels, there were statistically significant differences in the scores of sleeping habits, sleep latency, bedtime duration, sleep anxiety, night waking, parasomnias and daytime sleepiness in the improvement group (P<0.05), while there was statistically significant difference only in bedtime duration in the non-improvement group (P<0.05).Conclusion DDAVP treatment for 12 weeks can significantly improve the symptoms and sleep quality of children with MNE.

参考文献

[1] 中华医学会小儿外科学分会小儿尿动力和盆底学组和泌尿外科学组. 儿童遗尿症诊断和治疗中国专家共识[J]. 中华医学杂志, 2019, 99(21):1615-1620.
[2] 韩中将, 文一博, 汪玺正, 等. 儿童原发性遗尿症不同亚型患病率调查[J]. 中华小儿外科杂志, 2019, 40(12):1118-1122.
[3] 沈茜, 刘小梅, 姚勇, 等. 中国儿童单症状性夜遗尿疾病管理专家共识[J]. 临床儿科杂志, 2014, 32(10):970-975.
[4] Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents: Update report from the standardization committee of the International Children's Continence Society[J]. Neurourol Urodyn, 2016, 35(4):471-481.
[5] Neveus T, Eggert P, Evans J, et al. Evaluation of and treatment for monosymptomatic enuresis: a standardization document from the International Children's Continence Society[J]. J Urol, 2010, 183(2):441-447.
[6] Jain S, Bhatt GC. Advances in the management of primary monosymptomatic nocturnal enuresis in children[J]. Paediatr Int Child Health, 2016, 36(1):7-14.
[7] Tan TX, Wang Y, Cheah CSL, et al. Reliability and construct validity of the Children's Sleep Habits Questionnaire in Chinese kindergartners[J]. Sleep Health, 2018, 4(1):104-109.
[8] Radmayr C, Bogaert G, Dogan H, et al. EAU guidelines on paediatric urology[M]. EAU Guidelines, edition presented at the annual EAU Congress Barcelona. EAU. 2019.
[9] Tsuji S, Takewa R, Ohnuma C, et al. Nocturnal enuresis and poor sleep quality[J]. Pediatr Int, 2018, 60(11):1020-1023.
[10] Ma J, Li S, Jiang F, et al. Relationship between sleep patterns, sleep problems, and childhood enuresis[J]. Sleep Med, 2018, 50:14-20.
[11] Dossche L, Raes A, Hoebeke P, et al. Circadian Rhythm of Glomerular Filtration and Solute Handling Related to Nocturnal Enuresis[J]. J Urol, 2016, 195(1):162-167.
[12] Borg B, Kamperis K, Olsen LH, et al. Evidence of reduced bladder capacity during nighttime in children with monosymptomatic nocturnal enuresis[J]. J Pediatr Urol, 2018, 14(2): 160.e1-160.e6.
[13] Kamperis K, Van Herzeele C, Rittig S, et al. Optimizing response to desmopressin in patients with monosymp-tomatic nocturnal enuresis[J]. Pediatr Nephrol, 2017, 32(2):217-226.
[14] Bogaert G, Stein R, Undre S, et al. Practical recom-mendations of the EAU-ESPU guidelines committee for monosymptomatic enuresis-Bedwetting[J]. Neurourol Urodyn, 2020, 39(2):489-497.
[15] Chung E. Desmopressin and nocturnal voiding dysfunction: clinical evidence and safety profile in the treatment of nocturia[J]. Expert Opin Pharmacother, 2018, 19(3):291-298.
[16] Pedersen MJ, Rittig S, Jennum PJ, et al. The role of sleep in the pathophysiology of nocturnal enuresis[J]. Sleep Med Rev, 2020, 49:101228.
[17] Soster LA, Alves RC, Fagundes SN, et al. Non-REM sleep instability in children with primary monosymptomatic sleep enuresis[J]. J Clin Sleep Med, 2017, 13(10):1163-1170.
[18] Dhondt K, Baert E, Van Herzeele C, et al. Sleep frag-mentation and increased periodic limb movements are more common in children with nocturnal enuresis[J]. Acta Paediatr, 2014, 103(6):e268-e272.
[19] Van Herzeele C, Dhondt K, Roels SP, et al. Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep[J]. Pediatr Nephrol, 2016, 31(9):1477-1484.
[20] Rahm C, Schulz-Juergensen S, Eggert P. Effects of desmopressin on the sleep of children suffering from enuresis[J]. Acta Paediatr, 2010, 99(7):1037-1041.
[21] Bliwise DL, Holm-Larsen T, Goble S, et al. Delay of first voiding episode is associated with longer reported sleep duration[J]. Sleep health, 2015, 1(3):211-213.
[22] Gozmen S, Keskin S, Akil I. Enuresis nocturna and sleep quality[J]. Pediatr Nephrol, 2008, 23(8):1293-1296.
文章导航

/