联合多通道腔内阻抗-pH值(MII-pH):117名儿童正常值的多中心报告
Combined multichannel intraluminal impedance-pH (MII-pH): multicenter report of normal values from 117 children.
作者信息
Mousa Hayat, Machado Rodrigo, Orsi Marina, Chao Catherine S, Alhajj Tala, Alhajj Mark, Port Courtney, Skaggs Beth, Woodley Frederick W
机构信息
Division of Pediatric Gastroenterology, Nationwide Children's Hospital, 700 Children's Drive, JW 1985, Columbus, OH, USA,
出版信息
Curr Gastroenterol Rep. 2014 Aug;16(8):400. doi: 10.1007/s11894-014-0400-6.
Although combined multichannel intraluminal impedance/esophageal pH monitoring (MII-pH) has replaced prolonged pH monitoring alone for assessing gastroesophageal reflux (GER) in the pediatric population, it does so in the absence of reference values for non-acid GER (NAGER). The purpose of this study was to identify a normal range of NAGER impedance values for infants and children. We evaluated EPM/MII tracings for patients referred for GER assessment to Nationwide Children's Hospital (Columbus, OH), Inova Children's Hospital, and Hospital Italiano (Buenos Aires, Argentina). We excluded tracings from patients who had AGER indices greater than 50 % of the upper end of normal (i.e., >3 % for children >12 months and >6 % for infants ≤ 12 months), had a positive temporal association of GER with symptoms, were on anti-reflux medications at the time of the study, and/or had a fundoplication prior to the study. We also excluded studies with durations shorter than 20 h. Values for NAGER percent time, NAGER episode frequency, frequency of proximal NAGER, and mean NAGER duration were calculated for upright position, recumbent, and total. Study population consisted of 46 infants (20 female [F]/26 male [M], median age 4.8 months [range 3 weeks-11.9 months]) with a median AGER index of 2.2 % (range 0.0-5.9 %) and 71 children (22 F/49 M, median age 7.2 years [range 1.3-17 years]) with a median AGER index of 1.1 % (range 0-3.0 %). Data are presented in tables in the text. The results of this study provide a range of values characteristic of infants and children with normal AGER indices and no positive temporal associations of GER with symptoms. These values may be used as references for comparison to identify infants and/or children who may be at risk of developing serious clinical manifestations due to abnormal patterns of GER.
尽管联合多通道腔内阻抗/食管pH监测(MII-pH)已取代单纯的长时间pH监测来评估儿科人群的胃食管反流(GER),但在缺乏非酸性GER(NAGER)参考值的情况下进行了此项取代。本研究的目的是确定婴幼儿和儿童NAGER阻抗值的正常范围。我们评估了转诊至全国儿童医院(俄亥俄州哥伦布市)、Inova儿童医院和意大利医院(阿根廷布宜诺斯艾利斯)进行GER评估的患者的食管pH监测/多通道腔内阻抗描记图。我们排除了以下患者的描记图:AGER指数大于正常上限的50%(即12个月以上儿童>3%,12个月及以下婴儿>6%)、GER与症状存在阳性时间关联、在研究时正在服用抗反流药物和/或在研究前已进行胃底折叠术的患者。我们还排除了持续时间短于20小时的研究。计算了直立位、卧位和总体的NAGER时间百分比、NAGER发作频率、近端NAGER频率和平均NAGER持续时间的值。研究人群包括46名婴儿(20名女性[F]/26名男性[M],中位年龄4.8个月[范围3周-11.9个月]),中位AGER指数为2.2%(范围0.0-5.9%),以及71名儿童(22名F/49名M,中位年龄7.2岁[范围1.3-17岁]),中位AGER指数为1.1%(范围0-3.0%)。数据以表格形式呈现于文中。本研究结果提供了AGER指数正常且GER与症状无阳性时间关联的婴幼儿和儿童的一系列特征值。这些值可作为参考用于比较,以识别可能因GER异常模式而有发生严重临床表现风险的婴幼儿和/或儿童。