目的 分析频繁夜间遗尿症与出生窒息的关系,为频繁夜间遗尿症的病因研究提供实证依据。方法 于2014年6月-2015年6月按照分层整群随机抽样方法在上海市区3个区(静安、徐汇和杨浦)和郊区4个区(闵行、浦东、奉贤和崇明)选取62 290名5~12岁儿童为研究对象。采用多因素Logistic回归分析频繁夜间遗尿症与出生窒息的关系。 结果 上海市5~12岁儿童频繁夜间遗尿症的发病率为0.5%(327/62 290)。单因素Logistic回归分析显示频繁夜间遗尿症与出生窒息显著相关(OR=4.127,95%CI:2.994~5.690),多因素Logistic回归分析显示存在出生窒息的儿童仍具有患频繁夜间遗尿症的高风险(OR=3.001,95%CI:2.054~4.385,P<0.001),此外,还得出两者的相关性在男童中(OR=3.518,95%CI:2.275~5.438,P<0.001)比女童(OR=2.293,95%CI:1.041~5.051,P=0.039)更显著。结论 频繁夜间遗尿症与出生窒息显著相关,并且此相关性在男童中更高,提示出生窒息为频繁夜间遗尿的高危因素之一。
Abstract
Objective To explore the correlation between frequent nocturnal enuresis and birth asphyxia, in order to provide empirical evidence for clinical analysis of the etiology of frequent nocturnal enuresis. Methods A total of 62 290 children aged 5-12 years were selected in this study in Shanghai from June 2014 to June 2015 by a stratified cluster random sampling method. The correlation between frequent nocturnal enuresis and birth asphyxia was analyzed by multivariate Logistic regression. Results The incidence of frequent nocturnal enuresis in children aged 5-12 years was 0.5%(327/62 290). Univariate Logistic regression analysis showed that frequent nocturnal enuresis was significantly correlated with birth asphyxia (OR=4.127,95%CI:2.994-5.690,P<0.001). Multivariate Logistic regression analysis indicated that children with birth asphyxia still had a high risk of developing frequent nocturnal enuresis (OR=3.001,95%CI=2.054—4.385,P<0.001). In addition, the correlation between frequent nocturnal enuresis and birth asphyxia was closer in boys (OR=3.518, 95%CI:2.275—5.438,P<0.001) than that in girls (OR=2.293, 95%CI:1.041—5.051,P=0.039). Conclusion Frequent nocturnal enuresis is significantly associated with birth asphyxia, and the correlation is more closer in boys, indicating that birth asphyxia is a high risk factor for frequent nocturnal enuresis.
关键词
频繁夜间遗尿症 /
出生窒息 /
儿童
Key words
frequent nocturnal enuresis /
birth asphyxia /
children
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参考文献
[1] Austin PF, Bauer SB, Bower W, et al. The standardization of terminology of lower urinary tract function in children and adolescents:Update report from the standardization committee of the International Children's Continence Society[J]. Neurourology and Urodynamics,2016,35(4):471-481.
[2] 马骏,金星明.发育行为儿科中的功能性遗尿症[J].中国儿童保健杂志,2017,25(9):865-867,875.
[3] Safarinejad MR. Prevalence of nocturnal enuresis, risk factors, associated familial factors and urinary pathology among school children in Iran[J]. Journal of Pediatric Urology,2007,3(6):443-452.
[4] 王鲜艳,冯宇鹏,马恒颢.儿童原发性遗尿症与学习障碍相关性研究[J].人民军医,2016,59(12):1275-1277.
[5] 张安易,马骏.原发性遗尿症病因研究新进展[J].教育生物学杂志,2017,5(1):42-46.
[6] 廖正嫦,岳少杰.新生儿缺氧缺血综合征的研究进展[J].发育医学电子杂志,2019,7(1):19-23.
[7] Chen C, Jin Z, Yang Y, et al. Prevalence of grade 1, 2 and 3 thinness is associated with lower socio-economic status in children in Shanghai, China[J]. Public Health Nutrition,2016,19(11):2002-2010.
[8] Jin Z, Yang Y, Liu S, et al. Prevalence of DSM-5 autism spectrum disorder among school-based children aged 3-12 years in Shanghai, China[J]. J Autism Dev Disord,2018,48(7):2434-2443.
[9] von Gontard A. The impact of DSM-5 and guidelines for assessment and treatment of elimination disorders[J]. Eur Child Adolesc Psychiatry,2013,22(Suppl 1):61-67.
[10] Lord C,Elsabbagh M,Baird G. Autism spectrum disorder[J].Lancet(London,England),2018,392 (10146):508-520.
[11] 邵肖梅.实用新生儿学[M].4 版.北京:人民卫生出版社,2011:74.
[12] 房瑛娇.青岛市儿童和青少年原发性遗尿症流行病学调查[D].青岛:青岛大学,2019.
[13] Doganer YC, Aydogan U, Ongel K, et al. The Prevalence and sociodemographic risk factors of enuresis nocturna among elementary school-age children[J]. J Family Med Prim Care,2015,4(1):39-44.
[14] 刁宏旺,邓志梅,李守林,等.儿童原发性单症状夜间遗尿症发病的相关因素分析[J].精准医学杂志,2018,33(2):120-122,126.
[15] 邱萍,张璐,梁喜燕.新生儿窒息危险因素调查分析[J].河北医药,2020,42(1):134-136.
[16] Ornitz EM, Russell AT, Hanna GL, et al. Prepulse inhibition of startle and the neurobiology of primary nocturnal enuresis[J]. Biol Psychiatry,1999,45(11):1455-1466.
[17] Schulz-Juergensen S, Wunberg D, Wolff S, et al. Simultaneous EMG-fMRI during startle inhibition in monosymptomatic enuresis-an exploratory study[J]. Eur J Pediatr,2013,172(1):23-30.
[18] Iscan A, Ozkul Y, Unal D, et al. Abnormalities in event-related potential and brainstem auditory evoked response in children with nocturnal enuresis[J]. Brain & development,2002,24(7):681-687.
[19] Yu B, Xiao S, You Y, et al. Abnormal thalamic functional connectivity during light non-rapid eye movement sleep in children with primary nocturnal enuresis[J]. J Am Acad Child Adolesc Psychiatry, 2020,59(5):660-670.
[20] Laptook AR. Birth asphyxia and hypoxic-ischemic brain Injury in the preterm infant[J]. Clin Perinatol, 2016,43(3):529-545.
[21] Shankaran S, Barnes PD, Hintz SR, et al. Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy[J]. Arch Dis Child Fetal Neonatal Ed,2012,97(6):F398-F404.
基金
上海市2018年度医学引导类(中、西医)科研支撑项目(18411960200);上海市浦东新区科技发展基金(PKJ2017-Y06);上海市公共卫生体系建设三年行动计划(2011-2013)(11PH1951202)。