Division of Pediatric Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.
World J Urol. 2012 Aug;30(4):567-71. doi: 10.1007/s00345-011-0753-5. Epub 2011 Sep 7.
Decreased nocturnal antidiuretic hormone (ADH) excretion has been suggested to be a causative factor for PNE in children. We investigate the demographic characteristics and nocturnal ADH levels of children with PNE who attended a tertiary referral center and to determine their response to treatment with desamino-D-arginine vasopressin (DDAVP).
We performed a retrospective study in 90 PNE children aged 6-12 years. We recorded the gender, height, weight, number of children per family, and psychosocial problems and compared these findings with the corresponding data obtained from a national survey. We also measured the nocturnal ADH levels and evaluated the response rate to DDAVP.
The number of PNE patients decreased with an increase in age. Enuresis was significantly associated with male gender (P = 0.044) and more number of children per family (P = 0.043). The rates of comorbidity with defecation problems, obesity, attention-deficit hyperactivity disorder (ADHD), and overweight were 36.7, 17.8, 12.2, and 10%, respectively. Although the prevalence of obesity and ADHD was higher among children with PNE, there was no significant difference between PNE patients and their prevalence in the community. The ADH levels at 2 a.m. and 8 a.m. were 0.87 ± 0.75 and 0.89 ± 0.76 pg/ml, respectively. In the 50 (55.5%) patients who received DDAVP treatment, the complete- and partial response rates were 86 and 14%, respectively.
Our data confirmed that PNE was predominant in boys and larger family, and similar to the findings for disease prevalence, the number of children seeking treatment tended to decrease with increasing age. Low ADH levels were recognized as a possible cause of PNE, thereby explaining the good response to DDAVP treatment in Taiwanese children with PNE.
夜间抗利尿激素（ADH）分泌减少被认为是儿童夜间遗尿症（PNE）的一个致病因素。我们调查了在三级转诊中心就诊的 PNE 儿童的人口统计学特征和夜间 ADH 水平，并确定了他们对去氨加压素（DDAVP）治疗的反应。
我们对 90 名 6-12 岁的 PNE 儿童进行了回顾性研究。我们记录了性别、身高、体重、家庭中儿童的数量以及心理社会问题，并将这些发现与从全国性调查中获得的相应数据进行了比较。我们还测量了夜间 ADH 水平，并评估了 DDAVP 的反应率。
PNE 患者的数量随年龄的增长而减少。遗尿与男性性别（P=0.044）和家庭中儿童数量较多（P=0.043）显著相关。排便问题、肥胖、注意缺陷多动障碍（ADHD）和超重的合并症发生率分别为 36.7%、17.8%、12.2%和 10%。尽管 PNE 患儿中肥胖和 ADHD 的患病率较高，但与社区中的患病率相比，并无显著差异。凌晨 2 点和 8 点的 ADH 水平分别为 0.87±0.75 和 0.89±0.76 pg/ml。在接受 DDAVP 治疗的 50 名（55.5%）患者中，完全和部分反应率分别为 86%和 14%。
我们的数据证实 PNE 主要发生在男孩和较大的家庭中，与疾病流行率的发现相似，寻求治疗的儿童数量随着年龄的增长而减少。低 ADH 水平被认为是 PNE 的一个可能原因，这解释了 DDAVP 治疗对台湾 PNE 儿童的良好反应。
