摘要
目的探讨尿渗透压检测在儿童遗尿症诊治中的应用价值。方法50例原发性遗尿儿童,于治疗前测定夜间尿量及尿渗透压、夜间血清抗利尿激素(AVP),并给予口服去氨加压素(DDAVP)治疗,根据DDAVP的治疗反应分为有效(DR)35例,无效(DNR)15例。30例正常儿童对照组,测定夜间尿量和尿渗透压。结果遗尿儿童夜间尿渗透压与夜间尿量呈负相关(r=-0.506,P<0.05),与夜间AVP呈正相关(r=0.725,P<0.05)。DR儿童夜间尿渗透压水平为(682.71±213.95)mOsm/L,尿量为(265.14±164.48)ml,血清AVP浓度为(4.06±1.66)pg/ml;DNR患儿夜间尿渗透压水平为(1085.00±88.88)mOsm/L,尿量为(125.33±50.97)ml,血清AVP浓度为(7.27±1.48)pg/ml。两者比较差异均有统计学意义(P<0.001)。结论遗尿儿童夜间尿渗透压与尿量、血清AVP浓度有相关性。夜间尿渗透压可反映遗尿儿童夜间AVP的分泌水平。夜间尿渗透压降低的遗尿儿童夜间AVP分泌不足,对DDAVP治疗疗效好,尿渗透压的测定对选择DDAVP治疗有参考价值。
Objectives To evaluate the application of urine osmolality in the diagnosis and treatment of children with primary nocturnal enuresis. Methods Nocturnal urine volume, urine osmolality and serum vasopressin（AVP） were determined in 50 children with primary nocturnal enuresis before the oral administration of desmopressin（DDAVP）. After 3 months of treatment, children were divided into DDAVP-responsive group （DR, n = 35） and DDAVP-non responsive group （DNR, n = 15） . Nocturnal urine volume and osmolality were examined in 30 normal controls. Results The nocturnal urine osmolality was negatively correlated with volume （r = -0.506, P 〈 0.05 ） , while positively correlated with serum AVP level （r = 0.725, P 〈 0.05）. The average level of nocturnal urine osmolality in the DR group was （682.71 ± 213.95） mOsm/L vs （1 085.00 ± 88.88） mOsm/L in the DNR group. The nocturnal urine volume was （265.14 ± 164.48） ml in the DR group vs （125.33 ± 50.97） ml in the DNR group. Serum AVP level was （4.06 ± 1.66） pg/ml in the DR group vs （7.27 ± 1.48） pg/ml in the DNR group. Significant difference in each index was detected between two groups （P 〈 0.001） . Conclusions There are correlations among nocturnal urine osmolality, volume and serum AVP level in children with enuresis. Nocturnal urine osmolality could reflect the secretion level of nocturnal serum AVP of children with enuresis. Children exhibit a successful response to DDAVP therapy if they have low nocturnal urine osmolality and serum AVP level. The detection of urine osmolality provides an important reference for the DDAVP treatment.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2007年第5期399-401,共3页
Journal of Clinical Pediatrics
关键词
遗尿症
夜间尿渗透压
夜间尿量
抗利尿激素
nocturnal enuresis
nocturnal urine osmolality
nocturnal urine volume
vasopressin
