本研究分析原發性夜間遺尿病人和對照組年紀、性別、身高、身高百分位、
體重、體重百分位、喚醒分數七個變項中發現,原發性夜間遺尿病人的性別以男 性居多,喚醒分數比較高,而在年齡、身高、身高百分位、體重、體重百分位變 項中並無差異。
單一核苷酸鹼基變異方面,多症狀型原發性夜間遺尿包括便秘和白天頻尿分 析傾向5HTR2A變異在統計上有顯著的意義,顯示單一核苷酸多型性的分析可能
和原發性夜間遺尿分別評比較相關。本研究再次驗證了前人的看法,原發性夜間 遺尿是一群複雜的疾病和多基因調控。若是以夜間遺尿整體性的比較,可能因子 太多而更複雜,則較難得到有顯著的結果;須等到收集更多病人才會有出現較有 意義的結論。
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圖表
(表一) 臺灣地區原發性夜間遺尿流行病學的研究
2001 BJU International 87, 678–681
初診病人--原發性夜間遺尿評估表
9.現在使用藥物 □無 □有:_____________________
10.從睡眠中甦醒過來的評估分數_________
4.觀察排尿情形 □正常 □異常:______________________
C.實驗室檢查(醫師填寫)
1.必須的 □尿液分析 □尿比重 □腎臟超音波 □BUN/Creatinine □CBC管留全血 2 ㏄
2.選擇性的 □尿液細菌培養 □血清肌酐酸與鈉離子 □K.U.B □餘尿測量 □尿動力學 □口渴測試
□血清抗利尿激素
(圖一) 原發性夜間遺尿的形成三種主要的機轉
(表二) 原發性夜間遺尿候選基因選取(Candidate genes search)
rs13041148 sequence 4 270
rs5195 RFLP 1 Hpy99I 179
RFLP 2
rs9658588 RFLP 1 MspI 289
rs9658587 RFLP 1
rs16888557 RFLP 2 295
(表三)原發性夜間遺尿病童臨床表現和對照組的分析
Enuresis(-) Enuresis(+) P
n=62 n=99
Age (year)
10.58 ± 1.69 10.87 ± 2.82 0.143Sex (M/F)
32/30 52/47 0.031Height (cm)
138.85 ± 12.28 132.71 ± 16.5 0.637percentile
3.35 ± 1.42 3 ± 0.38 0.164Weight (Kg)
35.25 ± 10.4 33.07 ± 13.80 0.989percentile
3.16 ± 1.34 3 ± 0.38 0.611(表四)原發性夜間遺尿病童和正常兒童基因型和基因多型性頻率分析
Nocturnal enuresis Normal subjects P
No. (%) (n=99) No. (%) (n=62) Value*
Genotype
TT 42(42.4) 23(37.1) 0.731
TC 40(40.4) 29(46.8)
CC 17(17.2) 10(16.1)
Allelic frequency
Allele T 82(59.0) 52(57.1) 0.786 Allele C 57(41.0) 39(42.9)
(表五)原發性夜間遺尿病童有無合併頻尿基因型和基因多型性頻率分析
Frequency Non- frequency
PNo. (%) (n=36) No. (%) (n=63) Value*
Genotype
TT 21(58.3) 21(39.6)
0.037
TC 9(25.0) 31(58.4)
CC 6(16.6) 11(20.7)
Allelic frequency
Allele T 30(66.7) 52(55.3) 0.182 Allele C 15(31.3) 42(44.7)
(表六)原發性夜間遺尿病童難喚醒和易喚醒兩組基因型和基因多型性頻率分析
Arousal score
P6-8 2-5 Value*
(difficultly awaken)
(easily awaken) No. (%) (n=40) No. (%) (n=59)
Nocturnal enuresis patients
P with family history without family historyValue*
Patient No. (%) (n=45) Patient No. (%) (n=54)
(表八)原發性夜間遺尿病童有無便秘其基因型和基因多型性頻率分析
Nocturnal enuresis patients
P with constipation without constipationValue*
Patient No. (%) (n=33) Patient No. (%) (n=66) Genotype
TT 21(63.6) 21(31.8)
0.010
TC 8(24.2) 32(48.5)
CC 4(12.1) 13(19.7)
Allelic frequency
Allele T 29(70.7) 53(54.1) 0.172 Allele C 12(36.3) 45(45.9)
(表九)5HTR2A 基因多型性在原發性夜間遺尿病童不同的表現型間的分析
Controls NE (Total)
NE with DVS* NE with high arousal score
NE with constipate**
No. patients
Yes No Yes No Yes No (n=62) (n=99) (n=36) (n=63) (n=40) (n=59) (n=33) (n=64) Genotype
TT 23 42 21 21 21 21 21 21
TC 29 40 9 31 15 25 8 32
CC 10 17 6 11 4 13 4 13
Allelic frequency
T 52 82 30 52 36 46 29 53
C 39 57 15 42 19 38 12 45
* Genotype distribution in NE with and without DVS yielded statistically significant differences, P=0.037; * Genotype distribution in NE with constipation yielded statistically differences P=0.010