Tucci F, Resti M, Fontana R, Novembre E, Lami C A, Vierucci A
Department of Pediatrics, University of Florence, Italy.
J Pediatr Gastroenterol Nutr. 1993 Oct;17(3):265-70. doi: 10.1097/00005176-199310000-00006.
We evaluated the prevalence of gastroesophageal reflux in 36 children, 22 (61.2%) male and 14 (38.8%) female (median age, 75.5 months; range, 18-178), with noncontrolled asthma by means of prolonged (22-24 h) esophageal pH monitoring. None of the children had gastrointestinal symptoms suggesting gastroesophageal reflux. Atopy was seen in 21 of 36 (58.3%) patients. Pathological gastroesophageal reflux was present in 27 (75%) children. All patients were given cisapride (0.2 mg/kg q.i.d.) for 3 months. A clinical and pharmacological score was determined, and a second pH-metric study was made at the end of the follow-up period. The following pH-metric parameters were evaluated: the total percentage of time pH was < 4, the number of reflux episodes, the number of reflux episodes lasting > 5 min, the length of the longest single reflux episode, and the percentage of time the esophageal pH was < 4 during sleep. The study was completed in 11 of 27 children. The percentage of time that esophageal pH was < 4 improved in nine of 11 (81.8%) patients (p = 0.013). The percentage of time that esophageal pH was < 4 during sleep showed the most significant decrease (p = 0.002) after treatment. Improvement in both clinical and pharmacological scores was highly significant (p < 0.0001) in 19 of 27 patients, eight of whom did not want to repeat the pH study. We conclude therefore that gastroesophageal reflux is frequently associated with noncontrolled asthma and that medical therapy for reflux may improve the further course of respiratory disease.
我们通过延长（22 - 24小时）食管pH监测，评估了36例儿童胃食管反流的患病率，其中男性22例（61.2%），女性14例（38.8%）（中位年龄75.5个月；范围18 - 178个月），这些儿童患有未得到控制的哮喘。所有儿童均无提示胃食管反流的胃肠道症状。36例患者中有21例（58.3%）存在特应性。27例（75%）儿童存在病理性胃食管反流。所有患者均接受西沙必利（0.2 mg/kg，每日4次）治疗3个月。确定了临床和药理学评分，并在随访期结束时进行了第二次pH测量研究。评估了以下pH测量参数：pH < 4的总时间百分比、反流发作次数、持续时间> 5分钟的反流发作次数、最长单次反流发作的时长以及睡眠期间食管pH < 4的时间百分比。27例儿童中有11例完成了研究。11例患者中有9例（81.8%）食管pH < 4的时间百分比有所改善（p = 0.013）。治疗后，睡眠期间食管pH < 4的时间百分比下降最为显著（p = 0.002）。27例患者中有19例临床和药理学评分均有显著改善（p < 0.0001），其中8例患者不愿重复pH研究。因此，我们得出结论，胃食管反流常与未得到控制的哮喘相关，针对反流的药物治疗可能改善呼吸系统疾病的进一步病程。
