Unalacak Murat, Aydin Mustafa, Ermis Bahri, Ozeren Ali, Sogut Ayhan, Demirel Fatma, Unluoglu Ilhami
Department of Family Medicine, Faculty of Medicine, Zonguldak Karaelmas University, Turkey.
Tohoku J Exp Med. 2004 Sep;204(1):63-9. doi: 10.1620/tjem.204.63.
The pathogenesis of monosymptomatic nocturnal enuresis is controversial. Various urodynamic studies showed bladder hyperactivity in enuretic children. But the exact cause is not precisely known. The aim of this study was to understand whether the autonomic nervous system dysfunction is involved in this bladder hyperactivity or not. Heart rate variability measurement is widely used for evaluation of cardiac autonomic activity. We evaluated cardiac autonomic nervous system functions in monosymptomatic nocturnal enuretic children by using 24-hour Holter electrocardiogram. The study group consisted of 32 enuretic children (20 boys and 12 girls) and the control group consisted of 20 healthy children (12 boys and 8 girls). In these two groups, we assessed cardiac autonomic regulation by analysis of heart rate variability, and found a significantly higher parasympathetic activity in enuretic children than controls. We suggest that the parasympathetic nervous system hyperactivity plays a role in nocturnal enuresis by causing vesical hyperactivity in monosymptomatic enuretic children.
单纯症状性夜间遗尿症的发病机制存在争议。各种尿动力学研究表明，遗尿儿童存在膀胱功能亢进。但其确切病因尚不完全清楚。本研究的目的是了解自主神经系统功能障碍是否与这种膀胱功能亢进有关。心率变异性测量广泛用于评估心脏自主活动。我们通过24小时动态心电图评估单纯症状性夜间遗尿儿童的心脏自主神经系统功能。研究组由32名遗尿儿童（20名男孩和12名女孩）组成，对照组由20名健康儿童（12名男孩和8名女孩）组成。在这两组中，我们通过分析心率变异性评估心脏自主调节，发现遗尿儿童的副交感神经活动明显高于对照组。我们认为，副交感神经系统功能亢进通过导致单纯症状性遗尿儿童膀胱功能亢进，在夜间遗尿症中起作用。
