Assadamongkol K, Phuapradit P, Petsrikun K, Viravithya W
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1993 Oct;76 Suppl 2:49-54.
To evaluate the clinical significance of suspected symptoms of GER, 24-hour esophageal pH monitoring was performedin 55 children (mean age of 23.9 months). We used 24-hour esophageal pH monitoring as a gold standard for the diagnosis of pathological GER. The primary indication for the study included frequent vomiting, dysphagia and respiratory diseases (recurrent pneumonia, aspiration pneumonia, hyperreactive airway, apnea and stridor). Forty-seven per cent of these 55 children had pathological GER and 61.5 per cent of them were less than 1-year-old. The sensitivity of frequent vomiting, dysphagia and aspiration pneumonia as symptoms of GER was lowest (7.7%) Recurrent pneumonia had highest sensitivity (50%) but had lowest specificity (31%) among other presenting symptoms. All the other symptoms had high specificity (82.8-100%). Dysphagia, hyperreactive airway and apnea were the presenting symptoms with high positive predictability (100%, 80%, and 75% respectively). We suggest that all children who have a history of dysphagia, hyperreactive airway and apnea should be evaluated for GER.
为评估胃食管反流（GER）疑似症状的临床意义，对55名儿童（平均年龄23.9个月）进行了24小时食管pH监测。我们将24小时食管pH监测作为诊断病理性GER的金标准。该研究的主要指征包括频繁呕吐、吞咽困难和呼吸系统疾病（反复肺炎、吸入性肺炎、气道高反应性、呼吸暂停和喘鸣）。这55名儿童中47%患有病理性GER，其中61.5%年龄小于1岁。作为GER症状，频繁呕吐、吞咽困难和吸入性肺炎的敏感性最低（7.7%）。反复肺炎的敏感性最高（50%），但在其他症状中特异性最低（31%）。所有其他症状的特异性都很高（82.8 - 100%）。吞咽困难、气道高反应性和呼吸暂停是具有高阳性预测值的症状（分别为100%、80%和75%）。我们建议，所有有吞咽困难、气道高反应性和呼吸暂停病史的儿童都应接受GER评估。
