Dimson S B
Arch Dis Child. 1986 Nov;61(11):1104-7. doi: 10.1136/adc.61.11.1104.
A double blind crossover trial of 20 micrograms intranasal 1-deamino-8-d-arginine vasopressin (DDAVP) versus placebo was carried out in 17 children with intractable enuresis aged between 6 and 13 years who had failed to respond to drugs and an enuresis alarm. Fluid intake was not restricted. There was a significant reduction in the number of wet nights. Seven children (41%) were cured or showed considerable improvement, with strong evidence against any placebo effect. The best response was seen in children aged 10 years or over and if urine osmolality after DDAVP reached beyond 1000 mmol/kg or was already at this concentration. The degree of overnight rise in urine osmolality after treatment with DDAVP was not predictable but correlated well with the clinical improvement in nocturnal diuresis present in eight of the children. A further 12 children with equally refractory enuresis were given 20 micrograms of the active drug to take during their school journeys or holidays. Six of them had previously normal overnight urine osmolalities with only two successes, but of the six who had nocturnal diuresis before treatment, five became dry, suggesting that DDAVP acts largely by anti-diuresis and might be most useful in children with nocturnal polyuria.
对17名6至13岁难治性遗尿症儿童进行了一项双盲交叉试验，这些儿童对药物和遗尿警报器均无反应。不限液体摄入量。尿床夜数显著减少。7名儿童（41%）治愈或有显著改善，有力证据表明不存在任何安慰剂效应。10岁及以上儿童以及去氨加压素（DDAVP）治疗后尿渗透压超过1000 mmol/kg或已处于该浓度的儿童反应最佳。DDAVP治疗后夜间尿渗透压升高程度不可预测，但与8名儿童夜间利尿的临床改善情况密切相关。另外12名同样难治性遗尿症儿童在上学途中或假期服用20微克活性药物。其中6名儿童之前夜间尿渗透压正常，仅有2例成功，但6名治疗前有夜间利尿的儿童中有5名不再尿床，这表明DDAVP主要通过抗利尿起作用，可能对夜间多尿的儿童最有用。
