Heine R G, Button B M, Olinsky A, Phelan P D, Catto-Smith A G
Department of Gastroenterology, Royal Children's Hospital, Melbourne, Australia.
Arch Dis Child. 1998 Jan;78(1):44-8. doi: 10.1136/adc.78.1.44.
To establish the incidence of pathological gastro-oesophageal reflux (GOR) in newly diagnosed infants with cystic fibrosis and to identify clinical predictors of increased reflux.
26 infants with cystic fibrosis less than 6 months of age (14 male, 12 female; mean (SEM) age 2.1 (0.21) months, range 0.8 to 5.6 months) underwent prolonged oesophageal pH monitoring (mean duration 27.1 (0.49) hours; range 21.3 to 30.2 hours). Reflux symptoms, anthropometric variables, pancreatic status, meconium ileus, genotype, and chest x ray findings were correlated with pH monitoring data.
Five infants (19.2%) had an abnormal fractional reflux time of greater than 10%, seven (26.9%) of 5-10%, and 14 (53.8%) of below 5%. Infants who presented with frequent vomiting had a significantly higher fractional reflux time than infants who had infrequent or no vomiting. There was no significant association between abnormal chest x rays and pathological GOR. Sex, genotype, nutritional status, meconium ileus, and pancreatic enzyme supplementation were not significantly associated with pathological GOR.
About one in five newly diagnosed infants with cystic fibrosis had pathological GOR. Pathologically increased reflux was present before radiological lung disease was established. Apart from frequent vomiting, no useful clinical predictors of pathological reflux were found.
确定新诊断的囊性纤维化婴儿病理性胃食管反流（GOR）的发生率，并识别反流增加的临床预测因素。
26例年龄小于6个月的囊性纤维化婴儿（男14例，女12例；平均（标准误）年龄2.1（0.21）个月，范围0.8至5.6个月）接受了长时间食管pH监测（平均持续时间27.1（0.49）小时；范围21.3至30.2小时）。将反流症状、人体测量变量、胰腺状况、胎粪性肠梗阻、基因型和胸部X光检查结果与pH监测数据进行关联分析。
5例婴儿（19.2%）的反流分数时间异常，大于10%；7例（26.9%）为5%-10%；14例（53.8%）低于5%。频繁呕吐的婴儿反流分数时间显著高于呕吐不频繁或无呕吐的婴儿。胸部X光异常与病理性GOR之间无显著关联。性别、基因型、营养状况、胎粪性肠梗阻和胰腺酶补充与病理性GOR无显著关联。
约五分之一新诊断的囊性纤维化婴儿患有病理性GOR。在放射性肺病确诊之前就已存在病理性反流增加。除了频繁呕吐外，未发现病理性反流的有用临床预测因素。
