Yoshida Yukinori, Kameda Makoto, Nishikido Tomoki, Takamatu Isamu, Doi Satoru
Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Disease.
Arerugi. 2008 May;57(5):529-35.
In pediatric intractable asthma, there is occasionally an association with GERD (gastroesophageal reflux disease). It is not clear in which cases GERD should be suspected or how effective the GERD therapy is in treating the asthma.
Twenty-seven preschool children (<6 years of age) suffering from recurrent asthma attack in spite of asthma therapy underwent 24-hour esophageal pH monitoring. We examined retrospectively the incidence of GERD and the effectiveness of famotidine in GERD positive patients.
18 of the 27 patients (66.7%) had positive results (GERD positive group). In 12 of the 15 patients (80%) who underwent GERD therapy (famotidine), respiratory symptoms were decreased. In the GERD positive group, the incidence of acid reflux during waking hours was more frequent than during sleeping hours. In 8 of 12 patients (66.7%) in whom famotidine was effective, cough and wheeze often occurred during the daytime and corresponded with the time when acid reflux must commonly occurred.
We conclude that children suffering from recurrent asthma attack in spite of asthma therapy must be examined for the presence of GERD.
在儿童难治性哮喘中，偶尔会与胃食管反流病（GERD）相关。目前尚不清楚在哪些情况下应怀疑GERD，以及GERD治疗对哮喘的治疗效果如何。
27名尽管接受了哮喘治疗仍反复出现哮喘发作的学龄前儿童（<6岁）接受了24小时食管pH监测。我们回顾性地研究了GERD的发生率以及法莫替丁对GERD阳性患者的疗效。
27名患者中有18名（66.7%）结果呈阳性（GERD阳性组）。在接受GERD治疗（法莫替丁）的15名患者中的12名（80%）中，呼吸道症状有所减轻。在GERD阳性组中，清醒时的酸反流发生率比睡眠时更频繁。在法莫替丁有效的12名患者中的8名（66.7%）中，咳嗽和喘息常在白天发生，且与酸反流通常发生的时间一致。
我们得出结论，尽管接受了哮喘治疗仍反复出现哮喘发作的儿童必须检查是否存在GERD。
