Yakinci C, Müngen B, Durmaz Y, Balbay D, Karabiber H
Inönü University Medical School Department of Pediatrics, Malatya, Turkey.
Brain Dev. 1997 Nov;19(7):485-7. doi: 10.1016/s0387-7604(97)00069-7.
Nocturnal enuresis is involuntary urination during night sleep. The pathogenesis of nocturnal enuresis is controversial. Developmental delay, genetic factors, stress and psychological factors, and sleep abnormalities are considered to be the etiologic factors. Various urodynamic studies showed bladder hyperactivity in enuretic children. Since the cause of vesical hyperactivity is not clear, we investigated the possible role of autonomic nervous system dysfunction in these children. The study groups consisted of 41 enuretic (25 boys and 16 girls) and 30 healthy children (18 boys and 12 girls). Four non-invasive autonomic nervous system function tests (orthostatic test, Valsalva ratio, 30:15 ratio, heart rate responses to deep breathing) were carried out in both groups. The differences between the enuretic and control groups were statistically significant in the Valsalva and 30:15 ratios (P < 0.0005 and P < 0.005, respectively). The results of these two tests demonstrated parasympathetic nervous system hyperactivity. No abnormality of the sympathetic nervous system was found. We suggest that the parasympathetic nervous system hyperactivity shown in our study may be a cause of vesical hyperactivity in enuretic children.
夜间遗尿是指在夜间睡眠期间不自主排尿。夜间遗尿的发病机制存在争议。发育迟缓、遗传因素、压力和心理因素以及睡眠异常被认为是病因。各种尿动力学研究表明遗尿儿童存在膀胱活动亢进。由于膀胱活动亢进的原因尚不清楚，我们研究了自主神经系统功能障碍在这些儿童中可能发挥的作用。研究组包括41名遗尿儿童（25名男孩和16名女孩）和30名健康儿童（18名男孩和12名女孩）。对两组儿童均进行了四项非侵入性自主神经系统功能测试（直立试验、瓦尔萨尔瓦比率、30:15比率、深呼吸时的心率反应）。遗尿组和对照组在瓦尔萨尔瓦比率和30:15比率方面的差异具有统计学意义（分别为P < 0.0005和P < 0.005）。这两项测试的结果表明副交感神经系统活动亢进。未发现交感神经系统异常。我们认为，我们的研究中显示的副交感神经系统活动亢进可能是遗尿儿童膀胱活动亢进的一个原因。
