Liu Yakai,Si Feng,Wang Songyang,et al.Clinical characteristics and related factors of emotional and behavioral problems in children with family primary nocturnal enuresis[J].Journal of Clinical Pediatric Surgery,2023,22(02):112-117.[doi:10.3760/cma.j.cn101785-202211028-003]
家族聚集性遗尿儿童临床特征及情绪与行为异常的相关因素分析
- Title:
- Clinical characteristics and related factors of emotional and behavioral problems in children with family primary nocturnal enuresis
- Keywords:
- Enuresis; Physiopathology; Enuresis; Psychology; Child Behavior; Diurnal Enuresis; Nocturnal Enuresis; Root Cause Analysis
- 摘要:
- 目的 研究家族聚集性遗尿(family primary nocturnal enuresis,FPNE)临床特征及引起患儿情绪与行为异常的相关因素。 方法 收集2021年9月至2022年9月新乡医学院第一附属医院儿童遗尿门诊就诊的306例原发性遗尿症(primary nocturnal enuresis,PNE)患儿临床资料,包括一般资料调查表、长处与困难问卷、儿童睡眠调查表(pediatric sleep questionnaire,PSQ)。依据PNE患儿三代家族成员是否受累,分为家族聚集性遗尿组(FPNE组,45例)和散发性遗尿组(sporadic primary nocturnal enuresis,SPNE组,261例)。观察FPNE组患儿临床特征及情绪与行为改变情况 。 结果 FPNE组中,严重遗尿症(nocturnal enuresis,NE)、非单症状性NE、大便异常和夜间排尿次数≥2次的发生率分别为68%(31/45)、75%(34/45)、48%(22/45)和29%(13/45),显著高于SPNE组的35%(92/261)、47%(123/261)、24%(63/261)和11%(30/261),差异有统计学意义(P＜0.05)。13~16岁遗尿患儿人数在FPNE组的占比为44.4%(20/45),显著高于SPNE组的19.6%(51/261),差异有统计学意义(P＜0.05)。FPNE组中约 46.7%(21/45)符合常染色体显性遗传,约33.3%(15/45)符合常染色体隐性遗传,约20.0%(9/45)为多基因遗传。FPNE组患儿的情绪症状、多动症状和困难总分高于SPNE组,差异有统计学意义(P＜0.05)。Logistic回归分析显示,年龄大、学习成绩较差、PSQ总分高是FPNE儿童情绪症状的影响因素(P＜0.05);学习成绩较差、患有大便异常及膀胱功能障碍、PSQ总分高是FPNE儿童多动症状的影响因素(P＜0.05) 。 结论 FPNE有多种遗传方式,以常染色体显性遗传最常见,患儿情绪症状、多动症状发生率高,临床症状多且较严重,发生尿频、尿急的风险较高,且随年龄增长而不易治愈。
- Abstract:
- Objective To explore the clinical characteristics and related factors of emotional and behavioral abnormality in children with family primary nocturnal enuresis(FPNE).Methods From September 2021 to September 2022,clinical data were collected from 306 children with primary nocturnal enuresis at our enuresis clinic.General information questionnaire,strengths and difficulties questionnaire and Pediatric Sleep Questionnaire(PSQ).Children with PNE were divided into family primary nocturnal enuresis group(FPNE group,n=45)and sporadic primary nocturnal enuresis group(SPNE group,n=261)according to whether family members of the third generation were involved.The clinical characteristics,emotional and behavioral changes of FPNE group were analyzed.Results The incidences of severe NE,non-monosymptomatic nocturnal enuresis(NMNE),abnormal stool and nocturnal micturition ≥ twice in FPNE group were(68%,75%,48% and 42% respectively)significantly higher than sporadic enuresis group(SPNE group)(57%,47%,24% and 11% respectively).The difference was statistically significant(P<0.05).The number of enuresis children aged 13-16 years was 44.4%(20/45)in FPNE group and it was significantly higher than 19.2%(50/261)in SPNE group.The difference was statistically significant(P<0.05).In FPNE group,46.7%(21/45)children were autosomal dominant,33.3%(15/45)children were autosomal stealth inheritance and 20.0%(9/45)children showed polygenic inheritance.The total scores of emotional symptoms、hyperactivity symptoms and difficulties in FPNE group were higher than those in SPNE group.The difference is statistically significant(P<0.05).No significant inter-group difference existed in scores of conduct problems,peer communication or society(P>0.05).Logistic regression analysis indicated that age,poor academic performance and high total score of PSQ were the influencing factors of emotional symptoms in FPNE group.Poor academic performance,abnormal stool,bladder dysfunction and high total score of PSQ were the influencing factors of hyperactivity symptoms in FPNE children.Conclusion There are many ways of inheritance of FPNE,among which autosomal dominant inheritance is the most common,the incidence of emotional symptoms and hyperactive symptoms is high,and clinical symptoms are more serious,the risk of frequent and urgent urination is higher,and it is not easy to cure with age.
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备注/Memo
收稿日期:2022-11-13。
基金项目:国家自然科学基金(U1904208)
通讯作者:文建国,Email:wenjg@hotmail.com