原发性单症状性夜遗尿症患儿尿电解质水平与膀胱功能的相关性研究  

Study on the correlation between urinary electrolyte level and detrusor overactivity in children with primary monosymptomatic nocturnal enuresis

作　　者：刘奎[1] 张晨阳 张钦涌 王庆伟[3] 文建国[3] Liu Kui;Zhang Chenyang;Zhang Qinyong;Wang Qingwei;Wen Jianguo(Department of Pediatric Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Urinary Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Urinary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]河南科技大学第一附属医院小儿外科,洛阳471000 [2]河南科技大学第一附属医院泌尿外科,洛阳471000 [3]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《中华实用儿科临床杂志》2024年第9期678-682,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(U1904208)。

摘　　要：目的探讨原发性单症状性夜遗尿症(PMNE)患儿的尿电解质水平及其与膀胱逼尿肌过度活动(DO)的相关性。方法病例对照研究。对2015年2月至2020年1月郑州大学第一附属医院收治的60例5~12岁PMNE患儿进行回顾性分析。根据夜间动态尿动力学(AUM)检测结果,将患儿分为伴夜间DO组36例[男19例,女17例,年龄(9.4±2.1)岁,体重指数(BMI)(18.90±2.66)kg/m^(2)]和不伴夜间DO组24例[男16例,女8例,年龄(9.0±1.9)岁,BMI(18.85±2.50)kg/m^(2)]。检测白天、夜间尿量及尿电解质平均水平,组间比较采用t检验、χ^(2)检验或Mann-Whitney U检验,采用Spearman等级系数评估电解质平均水平与夜间膀胱储尿期最大逼尿肌压力的相关性。结果两组年龄、性别比例、BMI比较差异均无统计学意义(均P>0.05);伴夜间DO组夜间尿量[0.291(0.194,0.408)L]、夜尿多尿频率(33.0%)均低于不伴夜间DO组[0.420(0.298,0.673)L、62.5%](均P<0.05);伴夜间DO组夜间尿钠[(181.13±102.39)mmol/L]、尿钙[(3.68±2.44)mmol/L]和尿氯[(147.89±57.21)mmol/L]水平均高于不伴夜间DO组[夜间尿钠(132.15±67.42)mmol/L、尿钙(1.98±2.07)mmol/L和尿氯(110.95±54.27)mmol/L](均P<0.05),而夜间尿钾水平2组间比较差异无统计学意义(P>0.05);伴夜间DO组和不伴夜间DO组白天尿钠、尿钾、尿钙和氯水平差异均无统计学意义(均P>0.05);伴夜间DO组夜间尿钠[(181.13±102.39)mmol/L]、尿钙[(3.68±2.44)mmol/L]水平高于白天[尿钠(132.48±79.84)mmol/L和尿钙(1.48±1.20)mmol/L]水平(均P<0.05),而夜间尿钾和尿氯水平与白天比较差异均无统计学意义(均P>0.05);不伴夜间DO组白天与夜间尿钠、尿钾、尿钙和尿氯水平差异均无统计学意义(均P>0.05)。另外,伴夜间DO组夜间尿钙水平与储尿期最大逼尿肌压力呈正相关(r=0.501,P<0.05)。结论PMNE患儿的夜间尿钠、尿钙和尿氯水平增高可能是其发生夜间膀胱功能障碍重要原因之一。Objective To investigate the correlation between urinary electrolyte level and detrusor overactivity(DO)in children with primary monosymptomatic nocturnal enuresis(PMNE).Methods In this case control study,a retrospective analysis was performed on 60 PMNE children aged 5-12 years who were admitted to the First Affiliated Hospital of Zhengzhou University from February 2015 to January 2020.According to the results of ambulatory urodynamic monitoring(AUM),there were 36 patients in the nocturnal DO group[19 males and 17 females,mean age(9.4±2.1)years,mean body mass index(BMI)(18.90±2.66)kg/m^(2)],and 24 patients in the non-nocturnal DO group[16 males and 8 females,mean age(9.0±1.9)years,mean BMI(18.85±2.50)kg/m^(2)].Daytime and nighttime urine volume and average urine electrolyte levels were measured.t-test,Chi-square test or Mann-Whitney U test were used for comparison between groups.Spearman rating coefficient was used to evaluate the correlation between average electrolyte level and maximum detrusor pressure during nighttime bladder storage.Results There were no statistically significant differences in age,gender ratio,and BMI between the two groups(all P>0.05).The nocturnal urine volume[0.291(0.194,0.408)L]and the frequency of nocturnal polyuria(33.0%)in the nocturnal DO group were significantly lower than those[0.420(0.298,0.673)L and 62.5%](all P<0.05)in the non-nocturnal DO group.The levels of nocturnal urine sodium[(181.13±102.39)mmol/L],calcium[(3.68±2.44)mmol/L],and chloride[(147.89±57.21)mmol/L]in the nocturnal DO group were significantly higher than those[levels of nocturnal urine sodium(132.15±67.42)mmol/L],calcium[(1.98±2.07)mmol/L],and chloride[(110.95±54.27)mmol/L]in the non-nocturnal DO group(all P<0.05).However,there was no statistically significant difference in the level of nocturnal urine potassium between the two groups(P>0.05).The levels of diurnal urine sodium,potassium,calcium,and chloride showed no statistically significant differences between the two groups(all P>0.05).The levels o

关 键 词：儿童 原发性单症状性夜遗尿症 夜间逼尿肌过度活动 尿电解质 动态尿动力学 

分 类 号：R726.9[医药卫生—儿科]