胃食管反流病患儿的呼吸疾病往往更重.docVIP

胃食管反流病患儿的呼吸疾病往往更重 GERD Associated With Worse Infant Respiratory Disease 作者：MIRIAM E. TUCKER 来源：EGMN 2012-05-02 10:26点击次数：370发表评论 新浪微博 QQ书签 百度文库 人人网 开心网 豆瓣 EGMN ——美国过敏、哮喘与免疫学会年会上公布的一项研究显示，儿童胃食管反流病 GERD 与既往喘息史以及急性呼吸系统疾病严重程度更高均有关。 Robert S. Valet博士及其同事进行，共纳入430例因支气管炎或上呼吸道感染所致急性呼吸系统疾病而就诊的足月婴儿 0~12月龄 。通过向婴儿父母询问病史来确定有无GERD。 45例 10% 婴儿患有GERD。与无GERD组相比，GERD组中的白人比例较大并且具有过敏性鼻炎家族史的患者比例也较大，但两组在发病年龄、二手烟暴露或哮喘家族史方面无差异。此外，GERD组既往因喘息而接受治疗的患者比例 42% vs. 25% 和具有支气管炎的患者比例 84% vs. 71% 显著高于无GERD组。 GERD组和无GERD组的支气管炎严重程度中位评分 范围0~12分；评分越高说明疾病越严重，相差0.5分则具有临床意义 分别为5.5分和4.0分。校正年龄、种族、性别和二手烟暴露后，仍观察到GERD组的支气管严重程度评分高于无GERD组[比值比 OR 1.90]。GERD组和无GERD组需接受ICU治疗的患者比例分别为11%和5%，差异无显著性。 2GERD组的支气管炎严重程度评分高于无GERD组，喘息性疾病复发率也高于无GERD组 69% vs. 46%；OR 2.35；P 0.006 ；GERD组和无GERD组的沙丁胺醇使用率分别为52%和40%，差异无显著性 P 0.13 。2岁时，两组的哮喘诊断率无差异，分别为24%和22% P 0.76 。 GERD是否会同时降低支气管炎和哮喘严重程度。 Thrasher研究基金会资助。Valet博士声明无相关经济利益冲突。 有 BY MIRIAM E. TUCKERElsevier Global Medical NewsBreaking News ORLANDO EGMN – Gastroesophageal reflux disease was associated with prior wheezing and greater severity of infant acute respiratory illness in a study involving 430 term, healthy infants presenting with acute respiratory illness due to bronchiolitis or upper respiratory infection. New-onset gastroesophageal reflux disease GERD during bronchiolitis in previously health infants has been shown to increase the risk for respiratory failure Acta Paediatr. 2007;96:1025-9 . Bronchiolitis is a prominent risk factor for childhood asthma, and GERD is associated with worsened asthma severity J. Asthma 2011;48:366-73 . As yet unknown is whether preexisting GERD clinically significant reflux in infants modulates the severity of infant bronchiolitis or the diagnosis of childhood asthma, Dr. Robert S. Valet of Vanderbilt University, Nashville, Tennessee, and his associates said in a poster at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. The 430 infants, aged 0-12 months, were enrolled in the Tennessee Childrens