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目的探讨原发性夜遗尿症(PNE)儿童晨尿渗透浓度与非遗尿儿童有否差异,是否可以反映夜间抗利尿激素分泌水平。方法研究对象为2006-01—2006-08在华中科技大学同济医学院同济医院肾脏专科门诊就诊的患儿。用FM-8P冰点渗透浓度计前瞻性测定18例PNE患儿(病例组)和20例年龄、性别相匹配的非遗尿儿童(对照组)清晨(6:00～7:00)起床第1次尿和白天(14:00～15:00)随机尿的渗透浓度,采用酶联免疫吸附试验法测定凌晨1:00和下午15:00的血清抗利尿激素(ADH)水平。结果病例组晨尿渗透浓度[(682.06±222.68)mmol/L]比白天尿渗透浓度[(712.06±336.25)mmol/L]没有升高(P=1.000)且明显低于对照组晨尿渗透浓度[(911.40±235.98)mmol/L,P=0.023]及晨尿渗透浓度正常值低限(800mmol/L)(t=2.247,P=0.038);白天尿渗透浓度病例组和对照组分别为(712.06±336.25)mmol/L和(759.91±281.53)mmol/L,差异无显著性(P=1.000);血清ADH夜间(1:00)病例组为(1.58±0.35)pg/mL比白天[(15:00,2.48±1.72)pg/mL]无升高(P=0.834)且明显低于对照组夜间血ADH水平[(4.18±0.86)pg/mL,P=0.000],而对照组夜间ADH明显高于白天(15:00)[(2.10±1.35)pg/mL,P=0.002]。结论PNE患儿晨尿渗透浓度比白天没有升高且明显低于非遗尿儿童,与抗利尿激素夜间分泌减少相一致。提示晨尿渗透浓度可以间接反映PNE患儿夜间的抗利尿激素分泌情况。
Objective To investigate whether the urine concentration of morning urine in children with primary nocturnal enuresis (PNE) is different from those of non-nocturnal enuresis, and whether it can reflect the level of antidiuretic hormone secretion at night. Methods The study was performed on children with kidney specialist out-patient in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2006 to August 2006. 18 children with PNE (case group) and 20 age-matched and non-children with non-genital urine (control group) were prospectively determined to get up early in the morning (6: 00-7: 00) with the FM- Urine and daytime (14: 00 ~ 15: 00) random urine concentration, the use of enzyme-linked immunosorbent assay at 1 am and 15:00 of the serum anti-diuretic hormone (ADH) levels. Results The morning urine concentration [(682.06 ± 222.68) mmol / L] was not significantly higher than that of the control group ([712.06 ± 336.25] mmol / L] (P = 0.023) and the lower limit of normal urine concentration of morning urine (800mmol / L) (t = 2.247, P = 0.038). The daytime urinary osmolality in the patients and control groups were ((911.40 ± 235.98) mmol / 712.06 ± 336.25 mmol / L and 759.91 ± 281.53 mmol / L, respectively, with no significant difference between the two groups (P = 1.000). Serum ADH was (1.58 ± 0.35) pg / 15.00, 2.48 ± 1.72) pg / mL] (P = 0.834) and was significantly lower than that of the control group at night (4.18 ± 0.86 pg / mL, P = 0.000) Was significantly higher than during daytime (15:00) [(2.10 ± 1.35) pg / mL, P = 0.002]. Conclusions The urine concentration of morning urine in PNE children is higher than that in daytime and obviously lower than that in non-enuresis children, which is consistent with the reduction of nighttime secretion of vasopressin. Prompted morning urine penetration concentration can indirectly reflect the anti-diuretic hormone secretion in children with PNE at night.