Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37212, USA.
Gastroenterology. 2012 Apr;142(4):754-61. doi: 10.1053/j.gastro.2011.12.043. Epub 2012 Jan 5.
BACKGROUND & AIMS: Little is known about long-term health outcomes of children with dyspeptic symptoms. We studied the natural history of pediatric patients with dyspeptic symptoms, with and without histologic reflux, compared with healthy controls.
We performed a prospective study of consecutive new patients, ages 8-16 years, who underwent evaluation for dyspepsia, including upper endoscopy. Patients were assigned to groups with histologic evidence of reflux esophagitis (n = 50), or normal histology results (n = 53). Healthy children were followed up as controls (n = 143). Patients and controls were evaluated 5-15 years later. They provided self-reports on severity of dyspeptic symptoms, use of acid suppression, quality of life, anxiety, and depression.
When the study began, the groups with histologic evidence of esophagitis and normal histologies did not differ in severity of dyspeptic symptoms, functional disability, or depression. After a mean 7.6-year follow-up period, each group had significantly lower quality-of-life scores and more severe dyspeptic symptoms and functional disability than controls, but did not differ significantly from each other; both groups were significantly more likely than controls to meet criteria for an anxiety disorder. At time of follow-up evaluation, use of acid-suppression medication was significantly greater in the group with histologic evidence for esophagitis, compared with patients who had normal histology findings when the study began.
Among pediatric patients with dyspepsia evaluated by endoscopy and biopsy, those with histologic evidence for esophagitis or normal histology findings are at increased risk for chronic dyspeptic symptoms, anxiety disorder, and reduced quality of life in adolescence and young adulthood.
对于消化不良症状儿童的长期健康结果知之甚少。我们研究了伴有和不伴有组织学反流的消化不良儿科患者的自然病史，并与健康对照组进行了比较。
我们对连续的新患者进行了前瞻性研究，年龄为 8-16 岁，这些患者接受了消化不良评估，包括上内窥镜检查。患者被分为组织学证据表明有反流性食管炎的组（n = 50）或正常组织学结果的组（n = 53）。健康儿童作为对照组（n = 143）进行随访。患者和对照组在 5-15 年后进行评估。他们报告了消化不良症状的严重程度、酸抑制药物的使用、生活质量、焦虑和抑郁情况。
当研究开始时，组织学证据表明有食管炎和正常组织学的两组在消化不良症状的严重程度、功能障碍或抑郁方面没有差异。在平均 7.6 年的随访期间，每组的生活质量评分都明显较低，消化不良症状和功能障碍都比对照组更严重，但彼此之间没有显著差异；两组发生焦虑障碍的可能性都明显高于对照组。在随访评估时，与研究开始时组织学发现正常的患者相比，组织学证据表明有食管炎的组使用酸抑制药物的可能性明显更高。
在接受内窥镜和活检评估的消化不良儿科患者中，有组织学证据表明有食管炎或正常组织学发现的患者在青少年和成年早期发生慢性消化不良症状、焦虑障碍和生活质量下降的风险增加。
