去氨加压素对单症状遗尿症患儿症状及睡眠质量影响

doi:10.12372/jcp.2022.21e1237

Abstract

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.

Key words: desmopressin, monosymptomatic nocturnal enuresis, sleep, child

LYU Lei, WANG Yihe, HU Huijie, ZHAO Ying, LIU Erpeng, ZHANG Yanping, PU Qingsong, YANG Xinghuan, JI Fengping, WEN Jianguo. Effects of desmopressin on symptoms and sleep quality in children with monosymptomatic nocturnal enuresis[J].Journal of Clinical Pediatrics, 2022, 40(4): 294-299.

Figures/Tables 3

References 22

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项目	基线	第4周	第8周	第12周	统计量	P
每周遗尿夜晚数[M(P₂₅~P₇₅)]	4.0(3.0~4.3)	3.0(3.0~4.0)	3.0(2.0~3.0)	2.0(1.0~3.3)¹⁾	H=46.92	<0.001
CSHQ总分(x±s)	61.1±4.5	59.3±4.7	55.8±4.2	53.7±4.8¹⁾	F=33.84	<0.001
遗尿发生时间(x±s)/min	109.8±24.8	126.3±21.1	146.0±24.8	170.9±28.5¹⁾	F=69.01	<0.001
每日睡眠时间(x±s)/min
平时	562.2±33.1	577.7±32.2	587.4±28.55	593.4±31.8¹⁾	F=11.66	<0.001
周末	582.9±38.6	597.1±45.6	607.6±37.6	621.8±39.3¹⁾	F=10.27	<0.001

项目	改善组(n=40)	无改善组(n=22)	统计量	P
年龄(x±s)/岁	8.8±2.1	8.7±1.6	t=0.28	0.783
男性[n(%)]	23(57.5)	11(50.0)	χ²=0.32	0.570
每周遗尿夜晚数[M(P₂₅~P₇₅)]
基线	4.0(3.0~5.0)	4.0(3.0~4.0)	Z=1.06	0.287
第4周	3.0(3.0~4.0)	3.0(2.8~4.0)	Z=1.47	0.142
第8周	2.0(2.0~3.0)	3.0(3.0~3.0)	Z=2.84	0.005
第12周	1.5(1.0~2.0)	3.0(3.0~4.0)	Z=4.39	<0.001
遗尿发生时间(x±s)/min
基线	105.3±25.9	118.1±20.7	t=2.00	0.051
第4周	125.9±24.2	127.0±14.2	t=0.20	0.839
第8周	151.6±25.7	135.8±19.7	t=2.51	0.015
第12周	176.5±31.6	160.7±18.4	t=2.15	0.036
平时睡眠时间(x±s)/min
基线	561.5±32.8	563.5±34.5	t=0.23	0.821
第4周	584.0±33.2	566.1±27.2	t=2.17	0.034
第8周	595.8±28.2	572.2±22.6	t=3.37	0.001
第12周	601.0±30.8	579.7±29.5	t=2.64	0.011
周末睡眠时间(x±s)/min
基线	583.6±40.4	581.5±36.1	t=0.21	0.838
第4周	605.2±42.8	582.4±47.9	t=1.92	0.060
第8周	616.7±35.7	590.9±35.8	t=2.73	0.008
第12周	634.7±35.5	598.2±35.3	t=3.89	<0.001
CSHQ总分(x±s)
基线	61.8±4.6	60.0±4.2	t=1.48	0.144
第4周	59.3±5.1	59.3±4.1	t=0.03	0.973
第8周	54.8±4.4	57.7±3.1	t=2.78	0.007
第12周	52.0±4.6	56.7±3.3	t=4.25	<0.001

项目	组别	CSHQ评分				F值	P
项目	组别	基线	第4周	第8周	第12周	F值	P
就寝习惯	改善	12.1±1.1	11.4±1.3	10.3±1.4	9.2±1.3	39.11	<0.001
就寝习惯	无改善	11.7±1.0	11.6±1.2	11.1±0.9	11.1±0.9	2.43	0.071
入睡潜伏期	改善	2.6±0.6	2.4±0.6	1.9±0.5	1.5±0.5	31.52	<0.001
入睡潜伏期	无改善	2.3±0.7	2.2±0.5	2.1±0.5	2.1±0.7	0.68	0.569
睡眠持续时间	改善	6.0±0.8	5.7±0.9	4.9±0.8	4.4±1.0	29.19	<0.001
睡眠持续时间	无改善	5.9±0.8	5.8±0.8	5.5±0.7	5.2±0.7	3.27	0.025
睡眠焦虑	改善	9.9±1.2	9.2±1.4	8.4±1.2	7.8±1.3	21.73	<0.001
睡眠焦虑	无改善	9.3±1.0	9.3±0.9	9.1±1.1	8.6±0.9	2.24	0.089
夜醒	改善	3.8±0.8	4.1±0.8	4.3±0.7	4.6±1.0	7.56	<0.001
夜醒	无改善	4.2±0.7	4.2±0.8	4.2±0.6	4.3±0.8	0.17	0.916
异态睡眠	改善	11.7±1.0	11.4±1.1	10.9±0.9	10.6±1.0	10.20	<0.001
异态睡眠	无改善	11.6±1.1	11.5±1.2	11.1±1.0	10.8±1.0	2.38	0.075
睡眠呼吸暂停	改善	3.5±0.5	3.4±0.5	3.3±0.5	3.5±0.6	2.29	0.080
睡眠呼吸暂停	无改善	3.3±0.5	3.1±0.4	3.2±0.4	3.4±0.5	1.09	0.357
白天嗜睡	改善	12.3±1.3	11.9±1.3	10.9±1.1	10.3±1.3	19.56	<0.001
白天嗜睡	无改善	11.8±1.4	11.6±1.1	11.5±1.1	11.2±1.1	0.93	0.431

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

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