Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI.
Center for Pediatric Neurogastroenterology, Division of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI.
J Pediatr. 2014 May;164(5):1104-9. doi: 10.1016/j.jpeds.2014.01.046. Epub 2014 Mar 5.
To compare children with primary, chronic idiopathic nausea to those with secondary nausea associated with functional abdominal pain.
Retrospective chart review of 45 children with a primary complaint of chronic nausea several times per week. Comparisons were made to prospectively collected data on 49 children with functional abdominal pain and comorbid nausea.
The majority of those affected were adolescent Caucasian females. Subjects with chronic nausea had a more severe presentation with daily 88% (vs 26%) and constant 60% (vs 10%) nausea (P < .001), one-half with peak morning intensity. In the chronic nausea group, 62% had migraines, and 71% (vs 22%) had familial migraines (P < .001), 36% had postural tachycardia syndrome and 27% cyclic vomiting syndrome. Both groups suffered comorbid symptoms (anxiety, dizziness, fatigue, and sleep problems). The chronic nausea cohort underwent extensive, negative medical evaluations.
Chronic idiopathic nausea of childhood is a poorly described symptom. Patients with primary (vs secondary) chronic nausea were more likely Caucasian, older adolescent females with severe, daily nausea and comorbid conditions such as anxiety, dizziness, and fatigue as well as significantly more migraine features. Chronic nausea is a major, disabling symptom that requires increased recognition as a separate functional entity. Future studies may need to focus on comorbid conditions including migraine and dysautonomia.
比较原发性、慢性特发性恶心儿童与继发性恶心相关的功能性腹痛儿童。
对每周出现数次慢性恶心的 45 例儿童进行回顾性图表审查。将这些数据与前瞻性收集的 49 例功能性腹痛且伴有恶心的儿童数据进行比较。
受影响的大多数是青少年白人女性。慢性恶心患者的症状更严重，每日恶心发生率为 88%（vs. 26%），持续恶心发生率为 60%（vs. 10%）（P<.001），一半患者晨起时恶心最严重。在慢性恶心组中，62%的患者有偏头痛，71%（vs. 22%）有家族性偏头痛（P<.001），36%有体位性心动过速综合征，27%有周期性呕吐综合征。两组患者均有共病症状（焦虑、头晕、疲劳和睡眠问题）。慢性恶心组进行了广泛的、阴性的医学评估。
儿童慢性特发性恶心是一种描述不佳的症状。与继发性慢性恶心相比，原发性（vs. 继发性）慢性恶心患者更可能是白人，年龄较大的青少年女性，症状严重，每日恶心，伴有焦虑、头晕和疲劳等共病，偏头痛特征更为明显。慢性恶心是一种主要的、致残性症状，需要更加重视，将其视为一种独立的功能性实体。未来的研究可能需要关注偏头痛和自主神经功能紊乱等共病情况。
