Dutau G, Familiades J, Rochiccioli P
Poumon Coeur. 1977;33(6):351-9.
The respiratory symptoms of gastro-oesophageal reflux, which sometimes includes massive and fatal inhalation, are well-known in infants. In older children the digestive signs are not clinically evident and the reflux mainly, if not exclusively, can be translated by recurring respiratory symptoms. The series of 36 cases presented in this work concerns children between 3 months and 15 years old, for whom the first signs were respiratory, with often a silent gastro-oesophageal reflux for several months, and even several years in some cases. The physiopathology of the respiratory symptoms concerns principally the repeated alimentary aspiration and/or gastric content during nocturnal decubitus. The pulmonary lesions caused by the reflux can be either localized, with atelectasis, obstructive emphysema or bronchiectasis, or generalized with granulomatous reactions around the food particles. Other respiratory conditions such as asthma or cystic fibrosis can be also associated with gastro-oesophageal reflux. The diagnostic criteria are discussed.
胃食管反流的呼吸道症状在婴儿中广为人知,有时还包括大量吸入及致命性吸入。在大龄儿童中,消化症状在临床上并不明显,反流主要(若不是唯一的话)表现为反复出现的呼吸道症状。本研究中呈现的这36例病例涉及3个月至15岁的儿童,他们最初的症状是呼吸道症状,通常存在数月甚至在某些情况下数年的无症状胃食管反流。呼吸道症状的病理生理学主要涉及夜间卧位时反复出现的食物吸入和/或胃内容物吸入。反流引起的肺部病变可以是局部的,表现为肺不张、阻塞性肺气肿或支气管扩张,也可以是全身性的,表现为食物颗粒周围的肉芽肿反应。其他呼吸道疾病,如哮喘或囊性纤维化,也可能与胃食管反流有关。文中讨论了诊断标准。