喘息儿童一过性下食管括约肌松弛和酸反流的关系  

Transient lower esophageal sphincter relaxation and acid reflux in children with wheezing

作　　者：罗燕军[1] 胡赤军[1] 鲁明[1] 

机构地区：[1]湖北省妇幼保健院儿内科,武汉430070

出　　处：《中国医疗前沿》2011年第9期10-11,共2页China Healthcare Innovation

摘　　要：目的探讨喘息儿童酸反流发病机制中一过性下食管括约肌松弛及其与胃食管返流的关系。方法选取有典型喘息症状的儿童74例行24h食管pH监测和食管测压。根据pH<4总时间百分比<4%且Boix-Ochoa计分<11.99的标准,将受试者分为胃食管反流组(pH+组)和非胃食管返流组(pH-组)。结果喘息儿童胃食管反流发生率为66.2%(49/74),pH+组儿童食管pH监测的各项参数均明显高于pH-组儿童。pH+组食管下括约肌压力(LESP)明显低于pH-组[(12.1±6.8)Vs(33.5±5.6)mmHg,1mmHg=0.133kPa,P<0.05]。pH+组一过性LES松弛(TLESR)发生频率及TLESR持续时间明显高于pH-组[分别为(5.0±2.2)次/h Vs(2.6±1.3)次/h,(58.1±17.6)s Vs(22.7±15.4)s,均P<0.05]。与吞咽相关的LES松弛后收缩波幅(post-LESRA)在两组间亦存在显著差别[(37.0±18.9)mmHg Vs(71.8±17.2)mmHg,P<0.05]。结论喘息儿童酸反流发生率高,酸反流伴随TLESR发生频率增加,持续时间长。Objective To investigate the correlation between transient lower esophageal sphincter relaxation（TLESR） and acid reflux in children with wheezing.Methods Total of 74 children with wheezing were recruited and evaluated by 24-h pH monitoring and esophageal manometry.Children with wheezing were divided into reflux group（pH＋ group） and non-reflux group（pH-group） in accordance with the criteria of the total percentage time of pH below 4 less than 4% and Boix-Ochoa score11.99.Results In the group of wheezing children,there were 49 children with acid reflux（pH＋ group） and 25 children without acid reflux（pH-group）.Results of parameters of 24-h pH monitoring were significantly higher in pH^＋ group than those in pH-group（P〈 0.05）.The levels of lower esophageal sphincter pressure（LESP） [（12.1±6.8）mmHg,1mmHg=0.133kPa] of the pH＋ group was significantly lower than that of the pH-group[（33.5±5.6）mmHg,P 〈0.05].The occurrence and the duration of transient lower esophageal sphincter relaxation（TLESR） TLESR was increased in pH＋ group[（5.0±2.2）/h Vs（2.6±1.3）/h,（58.1±17.6）s Vs（22.7±15.4）s,respectively,P 0.05].The contractive amplitude of post lower esophageal sphincter relaxation was increased in pH＋ group[（37.0±18.9）mmHg Vs（71.8±17.2）mmHg,P 〈0.05].Conclusion Gastroesophageal reflux is popular in children with wheezing.It shows that TLESR is very important in the pathogenesis of wheezing children with acid reflux.

关 键 词：胃食管返流 儿童 喘息 食管括约肌 下段 一过性下食管括约肌松弛 

分 类 号：R57[医药卫生—消化系统]