Leluyer B, Denis P, Hellot M F, Mallet E, Pasquis P, Hellouin de Menibus C
Gastroenterol Clin Biol. 1984 Mar;8(3):228-33.
Twenty five infants, all under 3-year-old, 16 with symptoms of gastroesophageal reflux and 9 controls, were studied by continuous pH esophageal monitoring during 18 to 24 h. The diagnostic value of several pH parameters was calculated in reference to the upper limits of normal ranges previously determined in other studies performed in similarly aged children. Sensitivity and specificity of these parameters were respectively 69 and 89 p. 100 for the time elapsed below pH 4, 44 and 100 p. 100 for the number of reflux episodes per hour, 56 and 89 p. 100 for the duration of the longest episode of reflux, and 31 and 100 p. 100 for the number of reflux episodes lasting more than 5 min. These results confirm that a percentage Of reflux time (less than pH 4) longer than 5.2 p. 100 of the total duration of pH recording has the best discriminative value. However in clinical practice 2 or 3 h postprandial pH recording have a good diagnostic value when the results are expressed using a reflux score, as in adult patients. In further studies concerning gastroesophageal reflux in infants, it is concluded that diagnostic criteria must include evidence of reflux using a discriminant pH parameter.
25名3岁以下的婴儿接受了研究，其中16名有胃食管反流症状，9名作为对照，通过连续18至24小时的食管pH监测。参照先前在年龄相仿儿童中进行的其他研究确定的正常范围上限，计算了几个pH参数的诊断价值。对于pH低于4的持续时间，这些参数的敏感性和特异性分别为69%和89%；对于每小时反流发作次数，分别为44%和100%；对于最长反流发作的持续时间，分别为56%和89%；对于持续超过5分钟的反流发作次数，分别为31%和100%。这些结果证实，反流时间百分比（pH低于4）超过pH记录总时长的5.2%具有最佳的鉴别价值。然而在临床实践中，餐后2或3小时的pH记录在使用反流评分来表示结果时，具有良好的诊断价值，就如同在成年患者中一样。在关于婴儿胃食管反流的进一步研究中得出结论，诊断标准必须包括使用判别性pH参数的反流证据。
