Górecka-Tuteja Anna, Jastrzębska Izabela, Składzień Jacek, Fyderek Krzysztof
Department of Otolaryngology, Rydygier Memorial Specialistic Hospital, Cracow, Poland.
Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum Jagiellonian University, Cracow, Poland.
J Neurogastroenterol Motil. 2016 Jul 30;22(3):452-8. doi: 10.5056/jnm16013.
BACKGROUND/AIMS: To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry.
Children aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire.
Twenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH < 5.0 and a change in the pH value measured from the initial level at the upper sensor of > 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux.
LPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease.
背景/目的:采用24小时多通道腔内阻抗联合双探头(咽部和食管)pH值测定法,评估分泌性中耳炎(OME)患儿的喉咽反流(LPR)和胃食管反流(GER)的特征。
对7至10岁的OME患儿进行24小时多通道腔内阻抗pH值测定。上pH传感器位于食管上括约肌上方1 cm处,下pH传感器置于食管下括约肌上方3至5 cm处。要求家长通过儿科问卷完成胃食管反流症状评估。
共纳入28名儿童;19名(67.9%)儿童检测到LPR。LPR诊断标准为至少有一次食管上发作,pH值<5.0,且上传感器处pH值较初始水平变化>0.2。总共观察到64次发作。对所有LPR发作的评估显示,整个研究中共有246次发作。发现弱酸性发作占相当大的优势(87.8%);酸性发作占6.5%,弱碱性发作达5.7%。10名(35.7%)受试者存在病理性GER。8名儿童检测到酸性GER,其中2名表现为非酸性反流。在LPR阴性患者中,除1例非酸性反流外,未证实有病理性GER。
OME患儿组中经常发现LPR,它可能是这种常见疾病的一个重要危险因素。