醋酸去氨加压素治疗儿童原发性单症状性夜间遗尿症临床研究  

Clinical study of desmopressin acetate therapy on primary monosymptomatic nocturnal enuresis in children

作　　者：初梅[1] 曹力[1] 陈朝英[1] 陈大坤[1] 

机构地区：[1]首都儿科研究所附属儿童医院肾内科,北京100020

出　　处：《临床儿科杂志》2015年第12期1031-1034,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨醋酸去氨加压素治疗儿童原发性单症状性夜间遗尿症（MNE）的疗效、减停药指征及不良反应。方法选取2013年11月至2015年5月门诊就诊的MNE患儿151例,年龄5~14岁。按照方便抽样方法将其分为加压素治疗组（n=91）和对照组（n=60）,均进行行为心理治疗,加压素治疗组加用加压素治疗。加压素治疗组中能够达到减停药标准者,又分为药物减停组（n=32）和非减停组（n=28）。药物减停组在3个月内逐渐减停,非减停组直接停药;停药后观察1个月,记录复发情况。结果 91例加压素治疗组患儿中,61例（66.7%）治疗有效;21例（22.8%）部分有效;60例对照组中,5例（7.9%）治疗有效,17例（28.3%）部分有效;两组差异有统计学意义（χ2=75.64,P=0.00）。82例加压素治疗有效或部分有效者,最终进入药物减停组32例,非减停组28例。停药后观察1个月,两组复发分别为17例（54.8%）和24例（87.5%）,复发率差异有统计学意义（χ~2=7.329,P=0.007）。结论醋酸去氨加压素治疗MNE安全、有效,逐渐减停药物可减少复发。Objective To explore the effect, indication of reduction or discontinuation and side-effects of desmopressin acetate（DA） in treating primary monosymptomatic nocturnal enuresis PMNE in children. Methods Total 151 PMNE patients aged 5-14 years were recruited. According to convenience sampling method, the patients were divided into DA group（n=91） and control group（n=60）. Both groups were treated by behavioral psychotherapy, DA group were further treated by DA. In DA group, the patients who could reduction or discontinuation of DA were divided into gradually withdrawn group（n=32） and directly withdraw group（n=28）. The gradually withdrawn group was withdrawn the DA doses step by step in 3 months, and the directly withdrawn group was withdraw the DA doses at once. The recurrence of nocturnal enuresis was recorded within 1 month after DA withdrawal. Results In DA group, 91 patients, 61 patients（66.7%） treatment was effective, 21 patients（22.8%） was partial effective. In control group, 60 patients, 5 patients（7.9%） treatment was effective, 17 patients（28.3%） was partial effective. The effective rate was significantly different between two groups（χ2=75.64, P=0.00）. In the effective and partial effective patients, 32 cases underwent gradually DA withdrawal, 28 cases underwent directly withdrawal. 17 cases（54.8%） in gradually withdraw group and 24 cases（87.5%） in direct withdraw group were relapsed. The recurrence rate was significantly different between two groups（χ2=7.329, P=0.007）. Conclusions DA is a safe and effective way to treat PMNE. Gradually withdrawn the DA can decrease the recurrence.

关 键 词：遗尿症 去氨加压素 儿童 

分 类 号：R726.9[医药卫生—儿科]