Hjälmås K, Bengtsson B
Ostra Hospital, Gothenburg, Sweden.
Clin Pediatr (Phila). 1993 Jul;Spec No:19-24. doi: 10.1177/0009922893032001s05.
Desmopressin is a potent antidiuretic for nocturnal enuresis with few and mostly insignificant adverse reactions. Almost 80 years ago, the antidiuretic effects of extracts of the posterior pituitary were first reported. The molecular structure of the peptide vasopressin arginine vasopressin (AVP) became known in 1956, and by 1967, a synthesized modification of AVP, known as DDAVP, or desmopressin, was introduced. Toxicity studies performed on experimental animals support the conclusion that desmopressin is considerably more potent as an antidiuretic than AVP and has an exceptional safety margin. Further, clinical experience reveals that from 1974 to June 1992 only 21 patients using desmopressin had serious adverse reactions (water intoxication), and no fatalities occurred. Seven of 10 children with nocturnal enuresis who receive desmopressin stop their bedwetting completely or reduce it significantly, with best results noted in children over 10 years of age. Given these results, the preferred treatment in Europe for children with nocturnal enuresis is the sequential combination of desmopressin and the enuresis alarm.
去氨加压素是治疗夜间遗尿症的一种强效抗利尿药，不良反应少且大多不严重。近80年前，首次报道了垂体后叶提取物的抗利尿作用。肽类血管加压素精氨酸血管加压素（AVP）的分子结构于1956年为人所知，到1967年，一种合成修饰的AVP，即去氨加压素（DDAVP）被引入。对实验动物进行的毒性研究支持以下结论：去氨加压素作为抗利尿药比AVP效力更强，且具有出色的安全边际。此外，临床经验表明，在1974年至1992年6月期间，使用去氨加压素的患者中只有21例出现严重不良反应（水中毒），且无死亡病例。接受去氨加压素治疗的10名夜间遗尿症儿童中有7名完全停止尿床或尿床明显减少，10岁以上儿童效果最佳。鉴于这些结果，欧洲治疗夜间遗尿症儿童的首选方法是去氨加压素与遗尿报警器的序贯联合治疗。
