Martin M E, Grunstein M M, Larsen G L
Ann Allergy. 1982 Dec;49(6):318-22.
Gastroesophageal reflux (GER) has been reported in a high percentage of children with asthma. To investigate the relationship between GER and nocturnal asthma (NA), 25 pediatric patients with histories of NA were studied prospectively with three to 13 weeks of in-patient observation to document NA and quantitative day-time and night-time wheezing frequency. Two distinct groups of patients were identified: 17 patients with predominant day-time asthma (DA) and eight with prominent NA. All were studied with overnight esophageal pH recordings to detect GER during sleep while also monitoring clinical status. A reflux score (RS) was calculated to quantitate the severity of GER. Sixteen of 25 patients (64%) had abnormal GER, including all eight patients with NA. A significant positive correlation was found between the RS and the percentage of nights with wheezing, while age, serum theophylline level and pulmonary function at the time of study did not correlate with RS. The NA group also had significantly higher RS than the DA group. Three of the eight NA patients had the onset of clinical wheezing during an episode of GER. We conclude that there is a significant association between NA and GER independent of age, lung function and theophylline levels and that GER may induce NA in a subpopulation of patients with reactive airways.
据报道，哮喘患儿中胃食管反流（GER）的发生率很高。为了研究GER与夜间哮喘（NA）之间的关系，我们对25例有NA病史的儿科患者进行了前瞻性研究，进行了3至13周的住院观察，以记录NA以及日间和夜间喘息的定量频率。确定了两组不同的患者：17例以日间哮喘（DA）为主的患者和8例以NA为主的患者。所有患者均进行了夜间食管pH记录，以检测睡眠期间的GER，同时监测临床状况。计算反流评分（RS）以量化GER的严重程度。25例患者中有16例（64%）GER异常，包括所有8例NA患者。RS与喘息夜间百分比之间存在显著正相关，而研究时的年龄、血清茶碱水平和肺功能与RS无关。NA组的RS也显著高于DA组。8例NA患者中有3例在GER发作期间出现临床喘息。我们得出结论，NA与GER之间存在显著关联，独立于年龄、肺功能和茶碱水平，并且GER可能在一部分反应性气道患者中诱发NA。
