perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2020-65-1-30-36perinatology-1054Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSПсихосоматические коморбидные состояния при энурезе у детейPsychosomatic comorbid conditions in children with enuresishttps://orcid.org/0000-0002-5094-7599ЛетифовГ. М.LetifovG. M.

Летифов Гаджи Муталибович – д.м.н., проф., зав. кафедрой педиатрии с курсом неонатологии

344022 Ростов-на-Дону, пер. Нахичеванский, д. 29 

 

Rostov-on-Don

gmletifov@yandex.ruhttps://orcid.org/0000-0002-1316-5061БойкоН. В.BoikoN. V.

Бойко Наталья Владимировна – д.м.н., проф. кафедры болезней уха, горла, носа 

344022 Ростов-на-Дону, пер. Нахичеванский, д. 29 

Rostov-on-Don

ЛетифоваН. Г.LetifovaN. G.

Летифова Нелли Гаджиевна – врач-психиатр 

197022 Санкт-Петербург, ул. Чапыгина, д. 13

Saint Petersburg

ФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава РоссииРоссияRostov State Medical UniversityRussian FederationГУЗ Центр восстановительного лечения «Детская психиатрия им. С.С. Мнухина»РоссияMnuchin Children’s Psychiatry Rehabilitation CentreRussian Federation2020050320206513036Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20202020Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1054

Энурез представляет важную медицинскую и социально-психологическую проблему. Патофизиология энуреза остается невыясненной, ни одна из существующих теорий не может в полной мере объяснить его природу. В статье проведен систематический анализ исследований, рассматривающих роль обструктивных нарушений дыхания во сне в возникновении энуреза. Указанные нарушения у детей чаще всего обусловлены гипертрофией лимфоэпителиального глоточного кольца и сопряжены с множеством сопутствующих расстройств: легочная гипертензия, отставание в развитии, снохождение, синдром дефицита внимания и гиперактивности, синдром обструктивного апноэ во сне, энурез. Многочисленные исследования свидетельствуют о наличии корреляции перечисленных синдромов. Обструкция верхних дыхательных путей во время сна сопровождается повышением усилий дыхательной мускулатуры. Это вызывает увеличение отрицательного внутригрудного давления, что сопряжено с повышением содержания предсердного натрийуретического пептида и понижением секреции антидиуретического гормона. Хирургическое устранение обструкции дыхательных путей (аденотонзиллэктомия) в большинстве случаев приводит к значительному улучшению или полному исчезновения энуреза. Все это свидетельствует о необходимости комплексного междисциплинарного подхода к обследованию больных данной категории и их лечению с участием педиатров, психоневрологов и оториноларингологов.

Enuresis is a considerable medical and socio-psychological problem. The pathophysiology of enuresis remains unknown; none of the existing theories can explain its nature in full. The article reviews the studies devoted to the role of obstructive sleep disturbances in the occurrence of enuresis. The mentioned sleep disturbances in children are associated with other related disorders: pulmonary hypertension, developmental delay, sleepwalking, attention deficit and hyperactivity disorder, obstructive sleep apnea syndrome and enuresis. Numerous studies confirm the correlation of the mentioned syndromes. The obstruction of the upper respiratory tract during sleep is accompanied by an increase in the efforts of the respiratory muscles and negative intrathoracic pressure, which is associated with high atrial natriuretic peptide and low antidiuretic hormone levels. In most cases the surgical removal of respiratory tract obstruction (adenotonsillectomy) leads to significant improvement or complete resolution of enuresis. This category of patients requires a comprehensive interdisciplinary approach to the examination and treatment by the pediatricians, psycho-neurologists and ENT specialists.

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The authors declare that there are no conflicts of interest present.