近端食管胃酸反流与胃食管反流患儿呼吸道症状的关系

目的了解胃食管反流(GER)患儿近端食管胃酸反流与呼吸道症状发生的关系。方法采用食管双pH动态监测法，对31例单纯性呕吐、23例伴有反复呼吸道症状的GER患儿同时监测食管近端和远端pH值的变化，以35例健康儿作为对照组。结果单纯呕吐组远端食管各项酸反流指标、近端食管酸反流指标除最长反流时间外均大于对照组，差异有显著性；呼吸道症状组远端食管、近端食管各项酸反流指标均大于对照组，差异有显著性；但单纯呕吐组与呼吸道症状组相比较，无论在近端食管还是在远端食管，各项指标的差异无显著性；病例组远端食管各项酸反流指标均大于近端食管，差异有显著性。结论近端食管酸反流并不是GER患儿发生呼吸道症状的主要因素，而远端食管酸反流是小儿GER的主要反流形式。

Role of proximal gastric acid reflux in the development of respiratory symptoms in children with gastroesophageal reflux

Objective To understand the impact of proximal gastric acid reflux in the development of respiratory symptoms in children with gastroesophageal reflux(GER). Methods 24- hour esophageal pH monitoring with a dual pH probe were investigated in 31 children with GER and without respiratory symptoms,23 children with both GER and respiratory symptoms,and 35 healthy children as controls,respectively. Results All acid reflux indexes of distal esophagus and main acid reflux index of proximal esophagus were significantly higher in all GER children with or without respiratory symptoms than that in control group.No significant difference in each parameter of pH monitoring in both of proximal esophagus and distal esophagus was observed between GER children with respiratory symptoms and GER children without respiratory symptoms.However,each parameter of distal esophagus was significantly higher than that of proximal esophagus in all GER children with or without respiratory symptoms. Conclusions Proximal gastric acid reflux do not play a role in the development of respiratory symptoms in children with GER.Distal gastric acid reflux is a major form of reflux in children with GER regardless of the occurrence of respiratory symptoms.