使用多通道内pH阻抗测试对有症状的幼婴进行胃食管逆流的评估:来自单一中心的大型队列研究
Rochelle Sequeira Gomes1, Michael Favara1, Sheeja Abraham2
1Department of Neonatology, Thomas Jefferson University/Nemours, Philadelphia, Pennsylvania.
American journal of perinatology
|August 29, 2024
概括
多通道内阻抗和pH (MII-pH) 研究有助于鉴定婴儿胃食道逆流病 (GERD) 的特征. 在许多情况下,即使没有频繁或酸性反流事件,反流症的症状也会发生.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 诊断技术 诊断技术 诊断技术
背景情况:
- 胃食道逆流性疾病 (GERD) 在婴儿中很常见,呈现出各种症状.
- 准确的诊断对于将GERD与其他疾病区分开来,避免不必要的治疗至关重要.
- 多通道内阻抗和pH (MII-pH) 研究提供了一种全面的方法来评估反流事件.
研究的目的:
- 评估MII-pH在大量有症状的幼儿群体中的实用性.
- 在这个人群中描述胃食道逆流 (GER) 的发生和性质.
- 通过使用验证的指数,确定逆流事件和婴儿症状之间的时间关联.
主要方法:
- 对181名怀疑患有GERD的婴儿进行了回顾性队列研究,这些婴儿接受了MII-pH.
- 分析了超过4000小时的数据,确定了8480个反流事件 (酸性和非酸性).
- 利用症状指数 (SI) 和症状关联概率 (SAP) 来将症状与反流联系起来;通过事件频率或酸性反流指数来定义病态反流.
主要成果:
- 62.4%的婴儿显示出与反流事件的积极症状关联.
- 只有16%的婴儿患有病理性反流,10%的婴儿患有病理性反流和症状关联.
- 无酸性反流比酸性反流更常见;症状关联在窒息/口口方面是适度的,在呼吸暂停/胸/脱方面则较差.
结论:
- 在婴儿中,MII-pH是有效的GERD和时间症状关联的特征.
- 病理性反流在有症状的婴儿中不常见,但症状可以与反流联系起来,而不需要频繁或酸性事件.
- MII-pH有助于识别真正的GERD,可能减少不必要的治疗.
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