患有持续性哮喘和胃食管反流的儿童及青少年的夜间反流

Nocturnal reflux in children and adolescents with persistent asthma and gastroesophageal reflux.

作者信息

Molle Lucas Dalle, Goldani Helena A S, Fagondes Simone C, Vieira Vera G, Barros Sergio G S, Silva Paulo S, Silveira Themis R

机构信息

Pediatric Gastroenterology Unit, Hospital de Clinicas de Porto Alegre-UFRGS, Porto Alegre, RS, Brazil.

出版信息

J Asthma. 2009 May;46(4):347-50. doi: 10.1080/02770900802712948.

DOI:10.1080/02770900802712948

PMID:19484667

Abstract

BACKGROUND

A higher frequency of nocturnal gastroesophageal reflux (GER) in adult patients with respiratory symptoms has been demonstrated. The aim of this study was to determine the prevalence of nocturnal GER by using prolonged intraesophageal pH monitoring and compare it with spirometry results in children with persistent asthma.

METHODS

Thirty-eight patients with persistent asthma for at least 2 years were studied. Gastrointestinal symptoms suggestive of GER were considered as regurgitation, heartburn, and abdominal pain. All patients underwent prolonged intraesophageal pH study and spirometry. GER was considered positive when a reflux index (RI) was higher than 5%. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), forced mid-expiratory flow rate (FEF(25-75%)), and FEV(1)/FVC ratio were measured.

RESULTS

Median age was 10 years of age (range 5 to 15) and 58% were male; GER prevalence was 47.3%. Median (range) of reflux index during supine and upright periods from GER patients were, respectively, 8.7% (3.2 to 23.6) and 10.5% (5.2 to 15.0) (p = 0.913), and only FEF(25-75%) was below the predicted value: 54.5% (39.4 to 96.9). Reflux index was not significantly correlated with FVC, FEV(1) and FEF(25-75%).

CONCLUSIONS

A high prevalence of GER was found in children and adolescents with persistent asthma, equally distributed in the supine (nocturnal) and upright positions. There was no correlation with pulmonary function test.

摘要

背景

已有研究表明，有呼吸道症状的成年患者夜间胃食管反流（GER）的发生率较高。本研究的目的是通过长时间食管pH监测确定夜间GER的患病率，并将其与持续性哮喘儿童的肺功能测定结果进行比较。

方法

对38例患有持续性哮喘至少2年的患者进行了研究。提示GER的胃肠道症状包括反流、烧心和腹痛。所有患者均接受了长时间食管pH研究和肺功能测定。当反流指数（RI）高于5%时，GER被视为阳性。测量了用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、用力呼气中期流速（FEF₂₅₋₇₅%）和FEV₁/FVC比值。

结果

中位年龄为10岁（范围5至15岁），58%为男性；GER患病率为47.3%。GER患者仰卧位和直立位期间反流指数的中位数（范围）分别为8.7%（3.2至23.6）和10.5%（5.2至15.0）（p = 0.913），只有FEF₂₅₋₇₅%低于预测值：54.5%（39.4至96.9）。反流指数与FVC、FEV₁和FEF₂₅₋₇₅%无显著相关性。