胃食管反流性咳嗽症状严重度与胃食管反流程度的相关性  

Correlation between severity of gastroesophageal reflux cough and degree of gastroesophageal reflux disease

作　　者：唐素萍 刘艳琳 高虹 董李 林东如 陈燊 张丹云 张灵玲 潘娟 Tang Suping;Liu Yanlin;Gao Hong;Dong Li;Lin Dongru;Chen Shen;Zhang Danyun;Zhang Lingling;Pan Juan(Department of Allergy,Children＇s Hospital of Fuzhou,Teaching Hospital of Fujian Medical University,Fuzhou 350005,Chin)

机构地区：[1]福建省福州儿童医院变态反应科,350005 [2]福建省福州肺科医院儿科

出　　处：《中华儿科杂志》2018年第7期534-538,共5页Chinese Journal of Pediatrics

基　　金：福州市科技计划项目（2014-S-141-1）

摘　　要：目的探讨胃食管反流性咳嗽症状严重度与胃食管反流程度之间的相关性。方法收集2009年3月—2016年12月就诊于福州儿童医院变态反应专科门诊慢性咳嗽患儿共174例进行现况研究，采用食管24 h pH值动态监测方法检测胃酸反流指标，将高于正常值的患儿按反流严重度分为轻、中、重三组；按年龄段分为婴幼儿组（1-3岁）、学龄前组（4-6岁）、学龄组（〉7岁）；按夜（日）间咳嗽症状评分严重度分为轻、中、重三组。采用χ2检验、秩和检验进行组间比较分析，Spearman相关分析分别分析咳嗽严重程度与胃食管反流各指标的相关性。结果174例慢性咳嗽患儿中男115例、女59例；年龄（8.5±2.3）岁，年龄范围为1-15岁；平均病程（1.6±0.8）年。监测各项食管酸反流指标均高于正常值者有129例（74.1%），未见明显病理性胃食管反流45例（25.9%）。在129例胃食管酸反流患儿中，重度37例（28.7%）、中度23例（17.8%）、轻度69例（53.5%）。不同年龄组的胃食管反流轻、中、重度分布差异无统计学意义[婴幼儿组45.0%（9/20）、25.0%（5/20）、30.0%（6/20），学龄前组53.3%（32/60）、16.7%（10/60）、30.0%（18/60），学龄组57.1%（28/49）、16.3%（8/49）、26.5%（13/49）, χ2=1.204，P=0.877]，年龄分组及胃食管反流程度无关联（r=-0.065, P=0.489）。夜间咳嗽的严重程度与食管远端（CH1）的pH≤4总时间百分比，卧位pH≤4时间百分比和百分比DeMeester记分（〈14.72）高低均成正相关关系（r=0.689、0.621、0.707, P均〈0.05）。夜间咳嗽症状严重程度与立位pH≤4时间百分比的相关性差异未见统计学意义（r=0.113，P〉0.05），日间咳嗽严重程度与所有胃食管反流指标的相关性差异均无统计学意义（P均〉0.05）.结论胃食管反流性咳嗽的夜间咳嗽症状严重度与胃食管反流程度相关，应引起临床儿科医生的重视。ObjectiveTo explore the correlation between the severity of gastroesophageal reflux cough and degree of gastroesophageal reflux.MethodsA cross-sectional investigation was carried out. Data of 174 cases of chronic cough were collected in Children＇s Hospital of Fuzhou from March 2009 to December 2016. The esophageal 24 hours pH value dynamic monitoring was used to detect gastric acid reflux index. Cases with abnomal results were divided into mild, moderate and severe groups according to severity of reflux and that of day and night cough symptoms, respectively. They were also divided into infant （1-3 years old）, preschool （4-6 years old）, and school age （〉7 years old） groups according to age. Comparative analysis between groups by chi-square test and rank sum test were performed. Correlation analysis was used to analyze the correlation between cough severity and gastroesophageal reflux index.ResultsA total of 174 patients with chronic cough, including 115 males and 59 females, aged from 1 to 15 years with an average age of （8.5±2.3） years, and （1.6±0.8） years of disease duration were enrolled. Among them, 129 cases （74.1%） were positive for esophageal reflux test and 45 cases （25.9%） with no obvious pathological gastroesophageal reflux. Patients with positive esophageal reflux test were divided into severe （n=37, 28.7%）, moderate （n=23, 17.8%）, and mild （n=69, 53.5%）. There was no significant difference in the distribution of gastroesophageal reflux in each age group. （The proportions of mild, moderate and severe reflux in infants were 45.0% （9/20）, 25.0% （5/20）, and 30.0% （6/20）, respectively. The proportions of mild, moderate and severe reflux in preschool children were 53.3% （32/60）, 16.7% （10/60）, 30.0% （18/60）, respectively. The proportions of mild, moderate and severe reflux in school age children were 57.1% （28/49）, 16.3% （8/49）, 26.5% （13/49）, respectively χ2=1.204, P=0.877）. There was no correlation between age group and

关 键 词：咳嗽 胃食管反流 24小时食管pH值监测 

分 类 号：R725.7[医药卫生—儿科]