Kitamura Atsuko, Kondoh Tatsuro, Noguchi Mitsuru, Hatada Teppei, Tohbu Shohei, Mori Ken-Ichi, Matsuo Manabu, Kunitsugu Ichiro, Kanetake Hiroshi, Moriuchi Hiroyuki
Department of Pediatrics, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Pediatr Int. 2014 Dec;56(6):902-908. doi: 10.1111/ped.12367. Epub 2014 Oct 15.
Despite the fact that functional lower urinary tract symptoms are common among people with Down syndrome (DS), their voiding function has not been studied precisely. Our goal was to assess the lower urinary tract functions in DS.
Fifty-five DS children aged 5-15 years old and 35 age-matched control children were evaluated by ultrasonography and uroflowmetry.
Eleven (20%) DS children had no uresiesthesia, 21 (38%) were urinated under guidance, nine (16%) urinated fewer than three times a day, two (4%) urinated more than 10 times a day, three (5%) used diapers, and 26 (47%) had urinary incontinence. Seven (13%), 15 (27%), and 10 (18%) DS children had weak, prolonged and intermittent urination, respectively, and seven (13%) had urination with straining. In contrast, none of the control subjects had urinary problems. In the uroflowmetrical analysis, 10 (18%), 20 (37%), 11 (20%) and five (9%) DS children showed "bell-shaped," "plateau," "staccato" and "interrupted" patterns, respectively; the remaining nine (16%) could not be analyzed. In contrast, 21 (60%), one (3%), four (11%), three (9%) and two (6%) control subjects showed bell-shaped, tower-shaped, plateau, staccato and interrupted patterns, respectively; the remaining four (11%) could not be analyzed. Residual urine was demonstrated in four (7%) DS children and one (3%) control child.
Lower urinary tract symptoms and abnormal uroflowmetry findings, which can lead to further progressive renal and urinary disorders, are common in DS children. Therefore, lower urinary tract functions should be assessed at the life-long regular medical check-ups for subjects with DS.
尽管功能性下尿路症状在唐氏综合征（DS）患者中很常见，但其排尿功能尚未得到精确研究。我们的目标是评估DS患者的下尿路功能。
对55名5至15岁的DS儿童和35名年龄匹配的对照儿童进行了超声检查和尿流率测定。
11名（20%）DS儿童无尿意，21名（38%）在指导下排尿，9名（16%）每天排尿少于3次，2名（4%）每天排尿超过10次，3名（5%）使用尿布，26名（47%）有尿失禁。分别有7名（13%）、15名（27%）和10名（18%）DS儿童存在排尿无力、排尿延长和间歇性排尿，7名（13%）有排尿费力。相比之下，对照儿童均无排尿问题。在尿流率分析中，分别有10名（18%）、20名（37%）、11名（20%）和5名（9%）DS儿童表现出“钟形”“平台形”“断流形”和“间断形”模式；其余9名（16%）无法分析。相比之下，分别有21名（60%）、1名（3%）、4名（11%）、3名（9%）和2名（6%）对照儿童表现出钟形、塔形、平台形、断流形和间断形模式；其余4名（11%）无法分析。4名（7%）DS儿童和1名（3%）对照儿童有残余尿。
下尿路症状和异常尿流率测定结果在DS儿童中很常见，这可能导致进一步的进行性肾脏和泌尿系统疾病。因此，应在对DS患者进行的终身定期体检中评估下尿路功能。
