晨尿渗透压和儿童夜间遗尿症：一项单中心前瞻性队列研究。
First-morning urine osmolality and nocturnal enuresis in children: A single-center prospective cohort study.
机构信息
Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.
Department of Urology, Pusan National University Hospital, Busan, Korea.
出版信息
Investig Clin Urol. 2023 Sep;64(5):501-509. doi: 10.4111/icu.20220377.
PURPOSE
To investigate the treatment outcome of nocturnal enuresis (NE) according to first-morning urine osmolality (Uosm) before treatment.
MATERIALS AND METHODS
Ninety-nine children (mean age, 7.2±2.1 y) with NE were enrolled in this retrospective study and divided into two groups according to first-morning Uosm results, that is, into a low Uosm group (<800 mOsm/L; 38 cases, 38.4%) or a high Uosm group (≥800 mOsm/L; 61 cases, 61.6%). Baseline parameters were obtained from frequency volume charts of at least 2 days, uroflowmetry, post-void residual volume, and a questionnaire for the presence of frequency, urgency, and urinary incontinence. Standard urotherapy and pharmacological treatment were administered initially in all cases. Enuresis frequency and response rates were analyzed at around 1 month and 3 months after treatment initiation.
RESULTS
The level of first-morning Uosm was 997.1±119.6 mOsm/L in high Uosm group and 600.9±155.9 mOsm/L in low Uosm group (p<0.001), and first-morning voided volume (p=0.021) and total voided volume (p=0.019) were significantly greater in the low Uosm group. Furthermore, a significantly higher percentage of children in the low Uosm group had a response rate of ≥50% (CR or PR) at 1 month (50.0% vs. 24.6%; p=0.010) and 3 months (63.2% vs. 36.1%; p=0.009).
CONCLUSIONS
Treatment response rates are higher for children with NE with a lower first-morning Uosm.
目的
研究治疗前晨尿渗透压（Uosm）对遗尿症（NE）治疗结果的影响。
材料与方法
本回顾性研究纳入 99 例 NE 患儿（平均年龄 7.2±2.1 岁），根据晨尿 Uosm 结果分为两组，即低 Uosm 组（<800 mOsm/L；38 例，38.4%）或高 Uosm 组（≥800 mOsm/L；61 例，61.6%）。从至少 2 天的频率体积图表、尿流率、残余尿量和存在频率、尿急和尿失禁问卷中获取基线参数。所有患者均接受标准尿路治疗和药物治疗。在治疗开始后约 1 个月和 3 个月分析遗尿频率和反应率。
结果
高 Uosm 组晨尿 Uosm 水平为 997.1±119.6 mOsm/L，低 Uosm 组为 600.9±155.9 mOsm/L（p<0.001），低 Uosm 组晨尿排空量（p=0.021）和总排空量（p=0.019）明显更大。此外，低 Uosm 组在 1 个月（50.0% vs. 24.6%；p=0.010）和 3 个月（63.2% vs. 36.1%；p=0.009）时，具有≥50%反应率（CR 或 PR）的患儿比例明显更高。
结论
治疗前晨尿渗透压较低的 NE 患儿治疗反应率更高。
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