| 李梦凡,张康玉.原发性遗尿症儿童血清 25羟维生素 D水平分析[J].安徽医药,2026,30(11):2266-2271. |
| 原发性遗尿症儿童血清 25羟维生素 D水平分析 |
| Analysis of the serum content of 25-hydroxyvitamin D in children with primary nocturnal enuresis |
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| DOI：10.3969/j.issn.1009-6469.2026.11.027 |
| 中文关键词: 遗尿 25羟维生素 D 儿童 严重程度 |
| 英文关键词: Enuresis 25-hydroxyvitamin D Child Severity |
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| 中文摘要: |
| 目的分析原发性遗尿症( PNE)儿童血清 25羟维生素 D［25(OH)D］的含量。方法回顾性研究 2022年 9月至 2023年 4月就诊于山西省儿童医院门诊的 5~16岁 PNE儿童(病例组) 100例和体检儿童(健康组) 52例，测定入选儿童的血清 25(OH)D含量并完善病例组的临床资料，分析病例组及健康组血清 25(OH)D含量的关系；将病例组儿童根据其尿床频次分为非重度组和重度组，调整混杂因素，探究病儿血清 25(OH)D含量与 PNE严重程度的关系；再将病例组儿童根据其是否合并有日间下尿路症状分为非单症状组和单症状组，分析两组病儿血清 25(OH)D含量。结果病例组合并有维生素 D减少的比例明显高于健康组( 64.00%比 25.00%)，差异有统计学意义( χ2=20.82，P<0.001)病例组及健康组血清 25(OH)D含量比较，差异有统计学意义［(68.187±22.580)nmol/L比( 85.945±19.925)nmol/L，t=5.13，P<0.00，1］； 100例病例组儿童中，非重度组 47例( 47.00%)重度组 53例( 53.00%)，合并有维生素 D减少的比例高于非重度组( 73.58%比 53.19%)，重度组血清 25(OH)D含量低于非重度组，［( 61.756±21.436)nmol/L比( 75.439±21.828)nmol/L］，均差异有统计学意义(均 P<0.05)；采用多因素 logistic回归分析调整混杂因素后发现，维生素 D减少是重度 PNE的危险因素［OR=2.85，95%CI:(1.10，7.41)，P=0.031］；通过对血清 25(OH)D含量与 PNE严重程度的关系进行平滑曲线拟合及阈值效应分析发现血清 25(OH)D含量与 PNE严重程度之间呈非线性关系，当血清 25(OH)D含量小于拐点( 69.8 nmol/L)时，患重度 PNE的概率会随着血清 25(OH)D含量减少而增加［OR=0.92，95%CI:(0.88，0.97)，P=0.003］； 100例病例组儿童中，非单症状组 52例( 52.00%)单症状组 48例( 48.00%)两组病儿维生素 D减少情况及血清 25(OH)D含量均差异无统计学意义(均 P>0.05)。结论 PNE病儿,尤其是重度 PNE病儿,更容易合并有维生素 D减少，血清 25(OH)D含量更低，临床上应注意保证儿童 25(OH)D的营养支持。 |
| 英文摘要: |
| Objective To explore the serum content of 25-hydroxyvitamin D [25(OH)D] in children primary nocturnal enuresis (PNE). Methods A total of 100 children (case group) with PNE aged 5-16 years who attended the outpatient clinic of Shanxi Children's Hos-pital from September 2022 to April 2023 and 52 healthy children (control group) who underwent routine physical examination duringthe same period were enrolled. The serum content of 25(OH)D of the selected children was determined and the clinical data of the casegroup were collected. The relationship between serum 25(OH)D content between the case and control group was analyzed. Children inthe case group were further divided into non-severe and severe groups according to their frequency of bed-wetting. After adjusting forthe confounding factors, the relationship between serum 25(OH)D content and the severity of PNE was explored. Additionally, childrenin the case group were divided into non-single symptom and single symptom subgroup according to whether they had daytime lower uri-nary symptoms. Serum 25(OH)D content between the two subgroups were compared.Results The proportion of children with vitaminD deficiency/reduction in the case group was significantly higher than in the control group (64.00% vs. 25.00%,χ2=20.82, P<0.001).The serum content of 25(OH)D in the case group was significantly lower than that in the control group [(68.187±22.580) nmol/L vs. (85.945±19.925) nmol/L, t=5.13, P<0.001]. There were 47 cases (47.00%) in the non-severe subgroup and 53 cases (53.00%) in the se-vere subgroup among the 100 children in the PNE group. The proportion of vitamin D reduction in the severe subgroup was higher thanin the the non-severe subgroup (73.58% vs. 53.19%). The serum 25(OH)D content in the severe group was lower than that in the non-se-vere group [(61.756±21.436) nmol/L vs. (75.439±21.828) nmol/L], and the differences were significant (P<0.05). After adjusting for con-founders using multivariate logistic regression analysis, it was found vitamin D reduction was a risk factor for severe PNE [OR=2.85, 95%CI: (1.10,7.41), P=0.031]. Through the smooth curve fitting and threshold effect analysis of the relationship between serum 25(OH)D content and PNE severity, we found a non-linear relationship between the serum content of 25(OH)D and the severity of PNE. When serum 25(OH)D content was less than the inflection point (69.8 nmol/L), the probability of severe PNE would increase with the decreaseof serum 25(OH)D content [OR=0.92, 95%CI: (0.88, 0.97), P=0.003]. There were 52 (52.00%) in the non-single symptom subgroup and48 (48.00%) in single symptom subgroup among the 100 children in the PNE group. There was no significant difference in vitamin D re-duction and serum 25(OH)D between the two subgroups (both P>0.05).Conclusion Children with PNE, especially those with severePNE, are more likely to be combined with vitamin D reduction and lower serum 25(OH)D content. Clinically, attention should be paid to ensuring the nutritional support for 25(OH)D in children. |
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