Cresi Francesco, Cester Elena Andrea, Salvatore Silvia, De Rose Domenico Umberto, Ripepi Antonio, Magistà Anna Maria, Fontana Claudia, Maggiora Elena, Coscia Alessandra, Francavilla Ruggiero, Cristofori Fernanda
Neonatology and Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy.
Pediatric Department, Università dell'Insubria, Varese, Italy.
J Neurogastroenterol Motil. 2020 Jul 30;26(3):370-377. doi: 10.5056/jnm19205.
BACKGROUND/AIMS: Combined multichannel intraluminal impedance and pH monitoring (MII/pH) is considered the most accurate test to detect gastroesophageal reflux (GER), however lacking reference values. We aim to determine reference values for the pediatric population and to correlate these values with age and postprandial/fasting period.
We evaluated MII/pH traces from patients (newborns, infants, and children) admitted to 3 Italian hospitals and who underwent MII/ pH for suspected GER disease. Patients with MII/pH traces that showed significant symptom-reflux associations and/or a pathological reflux index (> 6% for newborns and infants, > 3% for children) were excluded. Traces were analysed in their entirety, and in the postprandial period (first hour after a meal) and the fasting period (the following hours before the next meal) separately.
A total of 195 patients (46 newborns, 83 infants, and 66 children) were included. Age positively correlated with frequency of acidic GER events ( = 0.37, < 0.05) and negatively associated with weakly acidic GER events ( = 0.46, < 0.05).
This study describes the distribution of MII/pH values in a pediatric population with normally acidic GER exposure and no significant association between GER events and symptoms. These MII/pH values may be used as reference values in clinical practice for a corrected GER disease diagnosis in the pediatric population.
背景/目的：联合多通道腔内阻抗和pH监测（MII/pH）被认为是检测胃食管反流（GER）最准确的方法，但缺乏参考值。我们旨在确定儿科人群的参考值，并将这些值与年龄以及餐后/空腹期相关联。
我们评估了意大利3家医院收治的疑似GER疾病并接受MII/pH检查的患者（新生儿、婴儿和儿童）的MII/pH记录。排除MII/pH记录显示症状与反流有显著关联和/或反流指数病理性升高（新生儿和婴儿>6%，儿童>3%）的患者。对记录进行整体分析，并分别分析餐后（进食后第一小时）和空腹期（下次进餐前的接下来几个小时）的记录。
共纳入195例患者（46例新生儿、83例婴儿和66例儿童）。年龄与酸性GER事件的频率呈正相关（=0.37，<0.05），与弱酸性GER事件呈负相关（=0.46，<0.05）。
本研究描述了正常酸性GER暴露且GER事件与症状无显著关联的儿科人群中MII/pH值的分布情况。这些MII/pH值可在临床实践中用作参考值，以校正儿科人群GER疾病的诊断。
