Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid ...Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management.展开更多
Background: gastroesophageal reflux (GER) plays a major role in the pathogenesis of pediatric chronic airway disease. Esophageal pH-monitoring (epHM) is the diagnostic gold standard for acid GER. To date, there are no...Background: gastroesophageal reflux (GER) plays a major role in the pathogenesis of pediatric chronic airway disease. Esophageal pH-monitoring (epHM) is the diagnostic gold standard for acid GER. To date, there are no cut-off values for chronically coughing children ruling out relevant GER. Methods: 24-hour, double-channel epHM was performed in 549 children (3 months to 16 years old) with chronic pulmonary disease. We stratified according to age as follows: ≤ 1.5 years, > 1.5 - 4 years, > 4 - 8 years, > 8 12 - 16 years. Following parameters were calculated for both channels: total number of reflux episodes, number of reflux episodes > 5 minutes, duration of the longest reflux episode, and reflux index. Results: according to the above given age classification, the median number of reflux episodes in the lower esophagus was 31, 27, 32, 34, and 42 and for the upper esophagus 20, 13, 15, 14, and 11 respectively. The median reflux index at the distal esophagus was 2.55, 2.1, 2.3, 2.15, and 1.9;at the upper esophagus it was 1.4, 1.0, 1.1, 0.9, and 0.6 respectively. Conclusions: our data contribute useful support to the evaluation of pediatric airway disease. We provide reference values for decisions in the exploration of children with airway disorders and suspected GER.展开更多
目的探讨慢性肾功能不全合并胃食管反流病患者血清尿素氮、肌酐及食管24 h pH值DeMeester评分与胃泌素的相关性。方法选取南京军区南京总医院门诊慢性肾功能不全合并胃食管反流病的患者42例,测定血清尿素氮、肌酐及胃泌素浓度,并行24 h...目的探讨慢性肾功能不全合并胃食管反流病患者血清尿素氮、肌酐及食管24 h pH值DeMeester评分与胃泌素的相关性。方法选取南京军区南京总医院门诊慢性肾功能不全合并胃食管反流病的患者42例,测定血清尿素氮、肌酐及胃泌素浓度,并行24 h食管pH监测,结果以DeMeester评分进行统计。观察患者肾功能及DeMeester评分与血清胃泌素的关系。结果血清尿素氮为(31.1±8.5)mg/dl,肌酐为(3.0±1.3)mg/dl,DeMeester评分为65.0±64.1,胃泌素为(63.5±18.7)pg/ml;血清尿素氮、肌酐和DeMeester评分与胃泌素均呈正相关,相关系数R2值分别为0.58、0.49、0.35。结论慢性肾功能不全患者出现胃食管反流症状可能是由于对胃泌素的清除减少和生成增多导致的胃酸分泌增加及反流增多所致。展开更多
基金Supported by The National Natural Science Foundation of China,Nos.81170079 and 81470276Shanghai Shenkang Hospital Development Center,No.SHDC12012211
文摘Refractory chronic cough due to gastroesophageal reflux is a trouble some condition unresponsive to thestandard medical anti-reflux therapy. Its underlying mechanisms may include incomplete acid suppression, non-acid reflux, transient lower esophageal sphincter relaxations and esophageal hypersensitivity. The diagnosis of this disorder depends on both the findings of multi-channel intraluminal impedance-pH monitoring and the subsequent intensified anti-reflux therapy. The strategies of pharmacological treatment for refractory chronic cough due to reflux include the optimization of proton pump inhibitors and add-on therapies with histamine H2 receptor antagonists, baclofen and gabapentin. However, the further study is needed to satisfy its management.
文摘Background: gastroesophageal reflux (GER) plays a major role in the pathogenesis of pediatric chronic airway disease. Esophageal pH-monitoring (epHM) is the diagnostic gold standard for acid GER. To date, there are no cut-off values for chronically coughing children ruling out relevant GER. Methods: 24-hour, double-channel epHM was performed in 549 children (3 months to 16 years old) with chronic pulmonary disease. We stratified according to age as follows: ≤ 1.5 years, > 1.5 - 4 years, > 4 - 8 years, > 8 12 - 16 years. Following parameters were calculated for both channels: total number of reflux episodes, number of reflux episodes > 5 minutes, duration of the longest reflux episode, and reflux index. Results: according to the above given age classification, the median number of reflux episodes in the lower esophagus was 31, 27, 32, 34, and 42 and for the upper esophagus 20, 13, 15, 14, and 11 respectively. The median reflux index at the distal esophagus was 2.55, 2.1, 2.3, 2.15, and 1.9;at the upper esophagus it was 1.4, 1.0, 1.1, 0.9, and 0.6 respectively. Conclusions: our data contribute useful support to the evaluation of pediatric airway disease. We provide reference values for decisions in the exploration of children with airway disorders and suspected GER.
文摘目的探讨慢性肾功能不全合并胃食管反流病患者血清尿素氮、肌酐及食管24 h pH值DeMeester评分与胃泌素的相关性。方法选取南京军区南京总医院门诊慢性肾功能不全合并胃食管反流病的患者42例,测定血清尿素氮、肌酐及胃泌素浓度,并行24 h食管pH监测,结果以DeMeester评分进行统计。观察患者肾功能及DeMeester评分与血清胃泌素的关系。结果血清尿素氮为(31.1±8.5)mg/dl,肌酐为(3.0±1.3)mg/dl,DeMeester评分为65.0±64.1,胃泌素为(63.5±18.7)pg/ml;血清尿素氮、肌酐和DeMeester评分与胃泌素均呈正相关,相关系数R2值分别为0.58、0.49、0.35。结论慢性肾功能不全患者出现胃食管反流症状可能是由于对胃泌素的清除减少和生成增多导致的胃酸分泌增加及反流增多所致。
