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目的:探讨原发性单症状性夜遗尿症(PMNE)患儿的尿电解质水平及其与膀胱逼尿肌过度活动(DO)的相关性。方法:病例对照研究。对2015年2月至2020年1月郑州大学第一附属医院收治的60例5～12岁PMNE患儿进行回顾性分析。根据夜间动态尿动力学(AUM)检测结果，将患儿分为伴夜间DO组36例[男19例，女17例，年龄(9.4±2.1)岁，体重指数(BMI)(18.90±2.66) kg/m 2]和不伴夜间DO组24例[男16例，女8例，年龄(9.0±1.9)岁，BMI(18.85±2.50 )kg/m 2]。检测白天、夜间尿量及尿电解质平均水平，组间比较采用 t检验、 χ2检验或Mann－Whitney U检验，采用Spearman等级系数评估电解质平均水平与夜间膀胱储尿期最大逼尿肌压力的相关性。 结果:两组年龄、性别比例、BMI比较差异均无统计学意义(均 P>0.05)；伴夜间DO组夜间尿量[0.291(0.194，0.408)L]、夜尿多尿频率(33.0%)均低于不伴夜间DO组[0.420(0.298，0.673)L、62.5%](均 P<0.05)；伴夜间DO组夜间尿钠[(181.13±102.39) mmol/L]、尿钙[(3.68±2.44) mmol/L]和尿氯[(147.89±57.21) mmol/L]水平均高于不伴夜间DO组[夜间尿钠(132.15±67.42)mmol/L、尿钙(1.98±2.07)mmol/L和尿氯(110.95±54.27)mmol/L](均 P<0.05)，而夜间尿钾水平2组间比较差异无统计学意义( P>0.05)；伴夜间DO组和不伴夜间DO组白天尿钠、尿钾、尿钙和氯水平差异均无统计学意义(均 P>0.05)；伴夜间DO组夜间尿钠[(181.13±102.39) mmol/L]、尿钙[(3.68±2.44) mmol/L]水平高于白天[尿钠(132.48±79.84) mmol/L和尿钙(1.48±1.20) mmol/L]水平(均 P<0.05)，而夜间尿钾和尿氯水平与白天比较差异均无统计学意义(均 P>0.05)；不伴夜间DO组白天与夜间尿钠、尿钾、尿钙和尿氯水平差异均无统计学意义(均 P>0.05)。另外，伴夜间DO组夜间尿钙水平与储尿期最大逼尿肌压力呈正相关( r＝0.501， P<0.05)。 结论:PMNE患儿的夜间尿钠、尿钙和尿氯水平增高可能是其发生夜间膀胱功能障碍重要原因之一。

Objective:To investigate the correlation between urinary electrolyte level and detrusor overactivity (DO) in children with primary monosymptomatic nocturnal enuresis (PMNE).Methods:In this case control study, a retrospective analysis was performed on 60 PMNE children aged 5-12 years who were admitted to the First Affiliated Hospital of Zhengzhou University from February 2015 to January 2020.According to the results of ambulatory urodynamic monitoring (AUM), there were 36 patients in the nocturnal DO group [(19 males and 17 females, mean age(9.4±2.1) years, mean body mass index (BMI)(18.90±2.66) kg/m 2], and 24 patients in the non-nocturnal DO group [16 males and 8 females, mean age(9.0±1.9) years, mean BMI(18.85±2.50) kg/m 2].Daytime and nighttime urine volume and average urine electrolyte levels were measured. t-test, Chi-square test or Mann-Whitney U test were used for comparison between groups.Spearman rating coefficient was used to evaluate the correlation between average electrolyte level and maximum detrusor pressure during nighttime bladder storage. Results:There were no statistically significant differences in age, gender ratio, and BMI between the two groups (all P>0.05).The nocturnal urine volume [0.291(0.194, 0.408) L] and the frequency of nocturnal polyuria (33.0%) in the nocturnal DO group were significantly lower than those [0.420 (0.298, 0.673) L and 62.5%](all P<0.05) in the non-nocturnal DO group.The levels of nocturnal urine sodium [(181.13±102.39) mmol/L], calcium [(3.68±2.44) mmol/L], and chloride [(147.89±57.21) mmol/L] in the nocturnal DO group were significantly higher than those [levels of nocturnal urine sodium [(132.15±67.42) mmol/L], calcium [(1.98±2.07) mmol/L], and chloride [(110.95±54.27) mmol/L] in the non-nocturnal DO group (all P<0.05).However, there was no statistically significant difference in the level of nocturnal urine potassium between the two groups ( P>0.05).The levels of diurnal urine sodium, potassium, calcium, and chloride showed no statistically significant differences between the two groups (all P>0.05).The levels of nocturnal urine sodium [(181.13±102.39) mmol/L] and calcium [(3.68±2.44) mmol/L] in the nocturnal DO group were significantly higher than the levels of diurnal urine sodium [(132.48±79.84) mmol/L] and calcium [(1.48±1.20) mmol/L](all P<0.05); however, there was no statistically significant difference in the levels of nocturnal urine potassium and chloride compared to diurnal levels (all P>0.05).In the non-nocturnal DO group, there were no statistically significant differences in the levels of diurnal and nocturnal urine sodium, potassium, calcium, and chloride (all P>0.05).Additionally, the level of nocturnal urine calcium in the nocturnal DO group was positively correlated with the maximum detrusor pressure during the bladder storage period ( r=0.501, P<0.05). Conclusions:The increased nocturnal urine sodium, calcium, and chloride levels in children with PMNE may be one of the important reasons for the occurrence of nocturnal bladder dysfunction.