儿童膀胱过度活动综合征与过敏的相关性分析

Correlation between overactive bladder and allergies in children

目的评价儿童膀胱过度活动综合征(OAB)与过敏的相关性。方法回顾性分析2020年1月至2022年1月于中国医科大学附属盛京医院小儿肾脏风湿科门诊诊断为OAB的663例儿童患者的临床特点,采用logistic回归分析儿童OAB的危险因素,评价抗组胺药物治疗儿童OAB的效果。收集部分OAB患儿血液及尿液标本,分析其中缓激肽和P物质水平。结果湿疹史、荨麻疹史、皮肤瘙痒史、蚊虫叮咬史、过敏性鼻炎史、过敏性咳嗽(含哮喘)史、食物过敏史、便秘史、血总IgE水平是儿童OAB的危险因素(P<0.05)。抗组胺药物治疗儿童OAB的有效率为95.5%,未发生不良反应,提示抗组胺治疗对儿童OAB的疗效及安全性良好,抗组胺治疗无效组OAB儿童合并荨麻疹的比例更高(P<0.05)。抗组胺治疗有效组OAB患儿血总Ig E水平高于无效组(P<0.05)。此外,OAB患儿尿液中缓激肽水平较正常儿童明显升高(P<0.05),P物质水平未见明显升高(P>0.05)。结论儿童OAB与过敏状态有关,既往呼吸道、消化道和皮肤过敏以及血总Ig E水平升高是儿童OAB的危险因素。抗组胺药物治疗儿童OAB安全有效。尿液中缓激肽与儿童OAB发病相关。

Objective To assess the clinical correlation between overactive bladder(OAB)and allergies in children.Methods The clinical characteristics of 663 children diagnosed with OAB in outpatient clinics between January 2020 and January 2022 were retrospectively analyzed,and logistic regression was used to analyze the risk factors for OAB and evaluate the effect of antihistamine drugs on OAB.Blood and urine samples of some children with OAB were collected to analyze the expression levels of bradykinin and substance P.Results A history of eczema,urticaria,pruritus,mosquito bites,allergic rhinitis,allergic cough with asthma,food allergies,constipation,and total blood IgE levels were risk factors for OAB in children(P<0.05).The efficacy rate of antihistamine treatment in children with OAB was 95.5%,and no adverse reactions were observed,indicating that the efficacy and safety of OAB in children receiving antihistamine treatment were good,and the proportion of children with OAB and urticaria in the antihistamine treatment group was higher(P<0.05).The total blood IgE levels in children with OAB in the effective group of antihistamine treatment were higher than those in the ineffective group(P<0.05).In addition,the expression level of bradykinin in the urine of children with OAB was significantly higher than in healthy children(P<0.05),while the level of substance P was not significantly increased(P>0.05).Conclusion OAB in children are related to their allergic status,children’s previous respiratory,digestive tract,and skin allergies,and significantly elevated blood IgE levels are risk factors for OAB in children.Antihistamine treatment of OAB in children is safe and effective.OAB in children may be related to urine bradykinin.