KW Lee, WKY Chan

Abstract

The objective of this retrospective study is to evaluate the effectiveness of using early morning urine osmolality as a predictor of response to oral desmopressin in children with primary monosymptomatic nocturnal enuresis. Children treated solely with oral desmopressin for primary monosymptomatic nocturnal enuresis, between the period of January 1997 and June 2002, were recruited for the study. Early morning urine osmolality was measured before the use of desmopressin. Response to desmopressin is classified as good, intermediate or poor according to the reduction in frequency of nocturnal enuresis after eight weeks of desmopressin therapy. Total 53 patients were recruited in the study while 12 of them were excluded. Forty-one children were evaluated. Male sex is predominant. After eight weeks of treatment, thirteen children were classified as good responders, 16 as intermediate responders and 11 as poor responders. The age at treatment and the frequency of nocturnal enuresis before treatment among the three groups were comparable without any statistical significance. The early morning urine osmolality from the good responders was 791±260 mosmol/kg, from the intermediate responders was 797±168 mosmol/kg, and from the poor responders was 865±233 mosmol/kg respectively. There is no statistically significant difference in early morning urine osmolality among the three groups by the ANOVA analysis, with p value >0.05. We conclude that early morning urine osmolality is not effective in predicting the response of a child with primary monosymptomatic nocturnal enuresis to oral desmopressin therapy.

本回顧性研究的目的，是評價以晨尿尿滲作為反映原發性單純型夜間遺尿症患兒口服垂體加壓素為檢測指標的有效性。以 1997 年 1 月至 2002 年 6 月，單一口服垂體加壓素的原發性單純型夜間遺尿症患兒作為研究對象。使用垂體加壓素前檢測晨尿尿滲。依據經 8 周垂體加壓素治療後發生夜間遺尿的頻率，將對垂體加壓素反應分為好、中等或差。本研究共有 53 名患兒參加，但最終 12 名退出。對 41 名患兒進行評估。男童為主。經 8 周加壓素治療後，13名患兒反應好，16 名為中等，11 名反應差。對三組間治療前發生夜間遺尿頻率、治療年齡比較無統計學意義。反應好的一組晨尿尿滲為 791?60 mosmol/kg，中等反映的一組為 797?68 mosmol/kg，反應差的一組為 865?33 mosmol/kg。經 ANOVA 統計分析，三組間晨尿尿滲無統計差別，p 值>0.05。結論為晨尿尿滲並不是單純型夜間遺尿症患兒口服垂體加壓素的良好指標。