Velepic M, Rozmanic V, Velepic M, Bonifacic M
Clinic of Otorhinolaryngology, Rijeka University Medical School, Kresimirova 42, 51000, Rijeka, Croatia.
Int J Pediatr Otorhinolaryngol. 2000 Oct 16;55(3):187-90. doi: 10.1016/s0165-5876(00)00396-7.
The purpose of this study is to examine the relation between gastroesophageal reflux and allergy as possible causes of chronic tubotympanal pathology. The 30 examined children (ages 2-13) were divided into two groups based on the otological criteria. The 16 examined children suffered from a secretory otitis, which lasted more than four months. Upon further examination with a microscope, seven of these children exhibited symptoms of the adhesive process of the middle ear. Furthermore, 14 patients suffered from a recurrent otitis, i.e. more than five cases of otitis per year, while five patients from this group suffered from a chronic otitis with a central defect of the tympanum. The method used for the examination of the gastroesophageal reflux consisted of a continual 24 h esophageal pH monitoring. The particular apparatus used for this included antimony electrode (Synetics Medical, Sweden), while the analysis we performed was processed through the PC software program Gastrosoft Inc. The reflux index higher than five was considered pathological. At the time of the gastroesophageal reflux examination, we also performed the allergological analysis. The presence of allergy was confirmed by three methods: the positive allergological anamnesis, the positive skin pick test and by the elevated quantities of specific IgEs (Pharmacia CAP system). The examination resulted in the following: 18 of the examined children suffered from the pathological gastroesophageal reflux (60%); further seven of our patients tested positive on the allergological test (23%); and the four who tested positive for allergy also suffered from the pathological gastroesophageal reflux (13%). In comparison with allergies, the pathological GER was substantially more frequent in the patients who suffered from chronic tubotympanal disorders.
本研究的目的是探讨胃食管反流与过敏作为慢性中耳病变可能病因之间的关系。30名接受检查的儿童（年龄在2至13岁之间）根据耳科标准分为两组。16名接受检查的儿童患有分泌性中耳炎，病程超过四个月。经显微镜进一步检查，其中7名儿童表现出中耳粘连过程的症状。此外，14名患者患有复发性中耳炎，即每年发作超过5次中耳炎，而该组中有5名患者患有慢性中耳炎并伴有鼓膜中央缺损。用于检查胃食管反流的方法包括连续24小时食管pH监测。为此使用的特定仪器包括锑电极（瑞典Synetics Medical公司），而我们进行的分析是通过PC软件程序Gastrosoft Inc处理的。反流指数高于5被认为是病理性的。在进行胃食管反流检查时，我们还进行了过敏学分析。通过三种方法确认过敏的存在：阳性过敏学史、阳性皮肤点刺试验以及特异性IgE（Pharmacia CAP系统）数量升高。检查结果如下：18名接受检查的儿童患有病理性胃食管反流（60%）；另外7名患者过敏学检测呈阳性（23%）；4名过敏检测呈阳性的患者也患有病理性胃食管反流（13%）。与过敏相比，病理性胃食管反流在患有慢性中耳疾病的患者中更为常见。
