不同类型夜间遗尿症患儿的睡眠呼吸特征及相关影响因素研究  

Study on sleep structure and respiratory characteristics of children with nocturnal enuresis through overnight polysomnography

作　　者：刘奎[1] 张钦涌 张晨阳 王庆伟[2] 文建国[2] LIU Kui;ZHANG Qinyong;ZHANG Chenyang;WANG Qingwei;WEN Jianguo(Department of Pediatric Surgery,First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471000,China;Department of Urology,First Affiliated Hospital of Zhengzhou University)

机构地区：[1]河南科技大学第一附属医院小儿外科,河南洛阳471000 [2]郑州大学第一附属医院泌尿外科

出　　处：《临床泌尿外科杂志》2024年第6期557-561,共5页Journal of Clinical Urology

基　　金：国家自然科学基金资助项目(No:U1904208)。

摘　　要：目的:探究夜间遗尿症(nocturnal enuresis,NE)患儿的睡眠呼吸特征和相关影响因素。方法:选取2021年6月—2023年3月于郑州大学第一附属医院确诊为NE的患儿45例,按照是否存在日间下尿路症状,分为单症状性夜间遗尿(monosymptomatic nocturnal enuresis,MNE)组与非单症状性夜间遗尿(non-monosymptomatic nocturnal enuresis,NMNE)组,对所有患儿进行整夜多导睡眠监测(polysomnography,PSG)并记录7天排尿日记。同期选取在我院因上尿路疾病就诊而无下尿路功能障碍的儿童25例为对照组,行PSG检查。结果:与对照组相比,NE患儿的睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、体重指数标准分数(BMI z-score)及皮质觉醒指数升高(均P<0.05),3组在血氧饱和度及平均血压之间均差异无统计学意义(均P>0.05)。相对于MNE组,NMNE组在非快速眼动睡眠中浅睡眠时相的所占睡眠时间百分及皮质觉醒指数显著增高[(61.1±9.5)%vs(48.0±10.6)%,(10.5±4.2)次/h vs(8.6±2.8)次/h,P<0.001],而平均心率显著降低[(69.5±5.7)次/min vs(82.7±4.3)次/min,P<0.001];并且NMNE组的BMI z-score高于MNE组[(1.7±0.5)vs(1.4±0.4),P<0.001]。皮质觉醒指数及AHI分别与每月遗尿夜晚数呈正相关(r=0.848,P<0.001;r=0.466,P=0.001)。结论:NE患儿睡眠呼吸障碍多见,发生率与日间下尿路症状、遗尿严重程度和肥胖呈正相关。Objective To investigate the sleep and respiratory characteristics and its related factors in children with nocturnal enuresis(NE).Methods A total of 45 children with NE from June 2021 to March 2023 were collected.They were categorized into monosymptomatic nocturnal enuresis(MNE)and non-monosymptomatic nocturnal enuresis(NMNE)groups.A control group contains 25 children without lower urinary tract dysfunction.All-night polysomnography(PSG)monitoring and a 7-day urination diary were carried out in all children.Results Compared with the control group,NE group showed an increase in sleep apnea hypopnea index(AHI),body mass index standard score(BMI z-score),and cortical arousal index(CAI)(P<0.05).There were no significant differences in blood oxygen saturation or mean blood pressure among the three groups(P>0.05).The NMNE group showed a significant increase in sleep time and CAI during the light sleep phase in non-rapid eye movement sleep([61.1±9.5]%vs[48.0±10.6]%,[10.5±4.2]times/h vs[8.6±2.8]times/h,P<0.001).Additionally,the average heart rate significantly decreased([69.5±5.7]times/min vs[82.7±4.3]times/min,P<0.001).The BMI z-score of the NMNE group was higher than that of the MNE group([1.7±0.5]vs[1.4±0.4],P<0.001).Both CAI and AHI were positively correlated with the days of enuresis per month(r=0.848,P<0.001;r=0.466,P=0.001).Conclusion Sleep breathing disorder in children with NE is common,and the incidence is associated with daytime lower urinary tract symptoms,severity level of NE and obesity in children with NE.

关 键 词：儿童 夜间遗尿症 多导睡眠监测 下尿路症状 睡眠呼吸紊乱 

分 类 号：R726.9[医药卫生—儿科]