Devitt H, Holland P, Butler R, Redfern E, Hiley E, Roberts G
Department of Paediatrics General Infirmary, Leeds LS2 9NS, UK.
Arch Dis Child. 1999 May;80(5):448-51. doi: 10.1136/adc.80.5.448.
To examine the relation between nocturnal vasopressin release and response to treatment with the vasopressin analogue 1-desamino-8-D-arginine vasopressin (DDAVP) in children with primary monosymptomatic nocturnal enuresis.
Children were recruited from a specific enuresis clinic and entered into a defined treatment programme. Nocturnal vasopressin concentrations were measured every 15 minutes over a four hour period during overnight admission.
Sixty seven children were eligible for entry into the study, 35 of whom agreed to overnight sampling. There was a quadratic relation between mean plasma AVP and response to treatment with DDAVP, with very high or very low concentrations being unresponsive. Plasma AVP profiles ranged from low concentrations with little variability to high concentrations with wide variability.
The ability to respond to DDAVP is related to endogenous AVP production and is influenced by neuronal patterning in early infancy. The best predictors of success with treatment were a past history of breast feeding, mean nocturnal AVP concentration, and the height of the child. The response was adversely affected by poor weight at birth and poor linear growth. The study suggests differing causes of nocturnal enuresis related to different patterns of AVP release.
研究原发性单症状性夜间遗尿症患儿夜间血管加压素释放与血管加压素类似物1-去氨基-8-D-精氨酸血管加压素（DDAVP）治疗反应之间的关系。
从特定的遗尿症诊所招募儿童并纳入既定的治疗方案。在夜间住院期间，每15分钟测量一次夜间血管加压素浓度，持续4小时。
67名儿童符合进入研究的条件，其中35名同意进行夜间采样。平均血浆血管加压素（AVP）与DDAVP治疗反应之间呈二次关系，浓度极高或极低时均无反应。血浆AVP水平范围从变异小的低浓度到变异大的高浓度。
对DDAVP的反应能力与内源性AVP产生有关，并受婴儿早期神经元模式的影响。治疗成功的最佳预测因素是既往母乳喂养史、夜间平均AVP浓度和儿童身高。出生时体重低和线性生长差会对反应产生不利影响。该研究表明夜间遗尿症的不同病因与AVP释放的不同模式有关。
