Tucci F, Resti M, Fontana R, Noccioli B, Mattei R, Monterisi N, Pellegrini T, Jenuso R, Adami Lami C
Dipartimento di Pediatria, Clinica Pediatrica III, Firenze, Italia.
Pediatr Med Chir. 1993 Jan-Feb;15(1):11-5.
The prevalence of gastroesophageal reflux (GER) in 86 children with respiratory disease (recurrent pneumonia, chronic cough, bronchial asthma) has been evaluated by mean of prolonged (22-24 hours) esophageal pH-monitoring. The following parameters were evaluated: the total percentage of time pH < 4 and the percent time the esophageal pH was < 4 while sleeping. None of the children had gastrointestinal symptoms suggesting GER and no neurological disorder was noted in any of the studied patients. The mean age was 68.98 +/- 46.46 months (range 14-189); 53 (61.6%) males and 33 (38.4%) females were considered in the study. Atopy was evidenced in 42/86 (48.8%) children (total IgE > 2SD in 42/86 and prick tests positiveness in 32/86. A pH-metry indicating pathological GER was present in 52/86 (60.5%) children: 39/62 (62.9%) patients with bronchial asthma, 5/10 (50%) subjects with chronic cough and 8/14 (57.2%) children with recurrent pneumonia. No significant difference in the diagnosis of GER was recorded between atopic or non-atopic patients. The children with abnormal pH-metric recording were also evaluated by upper gastrointestinal series and/or endoscopy. A conventional barium radiology was performed in 44/52 patients and confirmed GER in 19/44 (43.2%). Esophagitis was evidenced in 21/46 (45.7%) studied patients. The presence of esophagitis was significantly (p = 0.032) related to the total percentage of time pH < 4, but the most significant (p = 0.002) association was with the percent time the esophageal pH was < 4 during sleep.(ABSTRACT TRUNCATED AT 250 WORDS)
通过延长（22 - 24小时）食管pH监测，对86例患有呼吸系统疾病（复发性肺炎、慢性咳嗽、支气管哮喘）的儿童进行了胃食管反流（GER）患病率评估。评估了以下参数：pH < 4的总时间百分比以及睡眠时食管pH < 4的时间百分比。所有儿童均无提示GER的胃肠道症状，且研究的任何患者均未发现神经障碍。平均年龄为68.98 ± 46.46个月（范围14 - 189个月）；研究纳入了53名（61.6%）男性和33名（38.4%）女性。42/86（48.8%）的儿童有特应性表现（42/86总IgE > 2SD，32/86点刺试验阳性）。52/86（60.5%）的儿童pH测量显示存在病理性GER：39/62（62.9%）的支气管哮喘患者、5/10（50%）的慢性咳嗽患者和8/14（57.2%）的复发性肺炎儿童。特应性或非特应性患者在GER诊断方面无显著差异。pH测量记录异常的儿童还通过上消化道造影和/或内镜检查进行了评估。44/52例患者进行了传统钡剂造影，19/44（43.2%）证实存在GER。46例研究患者中有21例（45.7%）证实有食管炎。食管炎的存在与pH < 4的总时间百分比显著相关（p = 0.032），但最显著的关联（p = 0.002）是与睡眠期间食管pH < 4的时间百分比相关。（摘要截断于第250个单词）
