Harris P, Muñoz C, Mobarec S, Brockmann P, Mesa T, Sánchez I
Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago.
Child Care Health Dev. 2004 Jul;30(4):337-44. doi: 10.1111/j.1365-2214.2004.00432.x.
To establish the relationship between sleep apnoea and gastro-oesophageal reflux in infants and describe the clinical, demographic and pHmetric profile and the characteristic of the sleep polysomnography with a pH probe.
A total of 102 consecutive patients were evaluated. Parents were requested to fill out a questionnaire about symptoms and previous therapy. Gastro-oesophageal reflux was considered abnormal when the percentage of time with pH less than 4 was higher than 4% of total sleep time.
A total of 102 infants were enrolled, 53% males. Seventy-four per cent of the infants were full-term babies. At the moment of the polysomnography, the mean age of the sample was 2.6 months. Suspicion of apnoea was the most common clinical diagnosis prior to the study. Only two infants have abnormal electroencephalogram. Mild gastro-oesophageal reflux was seen in 37 (36%) infants, while 22 (21.5%) did not have any reflux episode, and the remaining 43 (42%) infants had reflux index in the pathologic range. Only one patient had an unequivocal temporal relationship between acid oesophageal reflux and respiratory pause with oxygen desaturation.
Infants with history of apnoea or acute life threatening event frequently had gastro-oesophageal reflux episodes which did not correlated with respiratory events, suggesting that gastro-oesophageal reflux and apnoea often occur in the same infant as two separate events.
建立婴儿睡眠呼吸暂停与胃食管反流之间的关系,并描述其临床、人口统计学和pH监测特征以及带pH探头的睡眠多导睡眠图特征。
对连续102例患者进行评估。要求家长填写一份关于症状和既往治疗情况的问卷。当pH值小于4的时间百分比高于总睡眠时间的4%时,胃食管反流被视为异常。
共纳入102例婴儿,其中53%为男性。74%的婴儿为足月儿。在进行多导睡眠图检查时,样本的平均年龄为2.6个月。在研究之前,呼吸暂停疑似是最常见的临床诊断。只有两名婴儿脑电图异常。37例(36%)婴儿出现轻度胃食管反流,22例(21.5%)未出现任何反流发作,其余43例(42%)婴儿的反流指数处于病理范围。只有一名患者在酸性食管反流与伴有氧饱和度下降的呼吸暂停之间存在明确的时间关系。
有呼吸暂停或急性危及生命事件病史的婴儿经常出现胃食管反流发作,且与呼吸事件无关,这表明胃食管反流和呼吸暂停在同一婴儿中常作为两个独立事件发生。