Boström Michaela, Thorsson Ola, Toth Ervin, Agardh Daniel
Department of Pediatrics, Unit of Endocrinology and Gastroenterology, Skåne University Hospital, Malmö, Sweden.
Department of Clinical Physiology, Skåne University Hospital, Malmö, Sweden.
BMC Gastroenterol. 2014 Dec 24;14:3. doi: 10.1186/s12876-014-0225-7.
Wireless pH-monitoring is an accurate method for diagnosing adults with gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the use of the Bravo capsule on children investigated for GERD in terms of safety, tolerability and feasibility before and after administration of proton pump inhibitors.
A Bravo capsule was inserted during upper endoscopy under general anaesthesia or deep sedation with propofol. 48-hour pH-metry was performed in 106 children (50 males, 56 females) at the median age of 11 years (range 17 months-18 years). On the second day of investigation, proton pump inhibitor (PPI) was given at a mean dose of 1.6 mg/kg (SD ±0.6 mg). The definition of GERD was set to a reflux index (RI) of ≥5% and DeMeester score (DMS) ≥14.7.
Application of the capsule was successful in 103 of the 106 children (97.2%) and interpretable in 99 of these 103 (96.1%). 49 of the children with interpretable results (49.5%) had GERD according to RI, while 51 (56.7%) had GERD according to DMS. After PPI was given on day 2, RI decreased from a median of 4.9% (range 0.3-63.4%) to 2.2% (0-58.0%), while DMS decreased from a median of 17.6 (range 2.2-207.6) to 8.2 (0.3-178.6), respectively (p < 0.0001). No severe adverse events were reported.
Wireless pH-metry is a safe and tolerable method when investigating children for GERD. PPI given on the second day of assessment provides additional information on response to treatment suggesting that pH-metry preferably should be extended to 48 hours.
无线pH监测是诊断成人胃食管反流病（GERD）的一种准确方法。本研究的目的是评估在质子泵抑制剂给药前后，Bravo胶囊在因GERD接受检查的儿童中的安全性、耐受性和可行性。
在全身麻醉或丙泊酚深度镇静下的上消化道内镜检查期间插入Bravo胶囊。对106名儿童（50名男性，56名女性）进行了48小时pH测量，中位年龄为11岁（范围17个月至18岁）。在检查的第二天，给予质子泵抑制剂（PPI），平均剂量为1.6mg/kg（标准差±0.6mg）。GERD的定义设定为反流指数（RI）≥5%且DeMeester评分（DMS）≥14.7。
106名儿童中有103名（97.2%）成功应用胶囊，其中103名中的99名（96.1%）结果可解读。根据RI，49名结果可解读的儿童（49.5%）患有GERD，而根据DMS，51名（56.7%）患有GERD。在第2天给予PPI后，RI从中位值4.9%（范围0.3 - 63.4%）降至2.2%（0 - 58.0%），而DMS从中位值17.6（范围2.2 - 207.6）降至8.2（0.3 - 178.6），差异均有统计学意义（p < 0.0001）。未报告严重不良事件。
在对儿童进行GERD检查时，无线pH测量是一种安全且耐受性良好的方法。在评估的第二天给予PPI可提供有关治疗反应的额外信息，提示pH测量最好延长至48小时。
