使用非卧床式pH值－咳嗽监测仪对儿童返酸和咳嗽进行的客观研究
2010/08/11
目的：目前，尚未有客观试验对儿童返酸和咳嗽之间的相关性进行研究。市售的pH值监测仪具有较低的捕获率 （0.25 Hz ），限制了对返酸和咳嗽的客观定量。本文旨在慢性咳嗽儿童中评价非卧床儿童返酸和咳嗽之间的相关性。
设计、研究单位和患者：年龄<14岁的慢性咳嗽患儿入选本研究。这些患儿怀疑存在返酸，考虑采用pH－咳嗽记录器进行非卧床式监测，该记录器能同时以较快的速度（10 Hz）同时监测咳嗽和pH值。
主要监测指标：返酸期间（pH<4持续>0.5 s）10 s、30 s、60 s及120 s内咳嗽次数。结果：20名儿童中共记录到5628次咳嗽。大部分咳嗽（83.9%）不依赖于返酸。120 s内出现咳嗽－反流（中位数19，IQR 3-45）和反流－咳嗽（24.5, 13-51）的频率相当。在10 s 和30 s 内，反流－咳嗽（10 s：中位数：2.5, IQR：0-7.25；30 s：6.5, 1.25-22.25）频率显著少于咳嗽－反流频率（10 s：27, IQR 15-65；30 s=24.5, 14.5-55.5）（P分别为0.0001和0.001）。60 s和120 s内未见显著差异。 10 s内咳嗽－反流频率（中位数1.0, IQR 0-8）显著少于30 s (P=0.006)和60 s (P=0.048)内非咳嗽－反流（中位数29.5, 15-67），而非120 s内非咳嗽－反流频率（P=0.47）。
结论：对于可能存在胃食管反流疾病的慢性咳嗽儿童，返酸和咳嗽存在的时间相关性不存在因果关系。
（陈欣 审校）
Arch Dis Child. 2010 Jun 1. [Epub ahead of print]
An objective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger.
Chang AB, Connor FL, Petsky HL, Eastburn MM, Lewindon PJ, Hall C, Wilson SJ, Katelaris PH.
Queensland Children’s Respiratory Centre and Queensland Children’s Medical Research Institute, Royal Children’s Hospital, Brisbane, Australia.
Abstract
Objective There are no objective ambulatory studies on the temporal relationship between reflux and cough in children. Commercial pHmetry loggers have slow capture rates (0.25 Hz) that limit objective quantification of reflux and cough. The authors aimed to evaluate if there is a temporal association between cough and acid pH in ambulatory children with chronic cough. Design, setting and patients The authors studied children (aged <14 years) with chronic cough, suspected of acid reflux and considered for pHmetry using a specifically built ambulatory pHmetry-cough logger that enabled the simultaneous ambulatory recording of cough and pH with a fast (10 Hz) capture rate. Main outcome measures Coughs within (before and after) 10, 30, 60 and 120 s of a reflux episode (pH<4 for >0.5 s). Results Analysis of 5628 coughs in 20 children. Most coughs (83.9%) were independent of a reflux event. Cough-reflux (median 19, IQR 3-45) and reflux-cough (24.5, 13-51) sequences were equally likely to occur within 120 s. Within the 10 and 30 s time frame, reflux-cough (10 s=median 2.5, IQR 0-7.25; 30 s=6.5, 1.25-22.25) sequences were significantly less frequent than reflux-no cough (10 s=27, IQR 15-65; 30 s=24.5, 14.5-55.5) sequences, (p=0.0001 and p=0.001, respectively). No differences were found for 60 and 120 s time frame. Cough-reflux sequence (median 1.0, IQR 0-8) within 10 s was significantly less (p=0.0001) than no cough-reflux sequences (median 29.5, 15-67), within 30 s (p=0.006) and 60 s (p=0.048) but not within 120 s (p=0.47). Conclusions In children with chronic cough and suspected of having gastro-oesophageal reflux disease, the temporal relationship between acid reflux and cough is unlikely causal.
Arch Dis Child. 2010 Jun 1. [Epub ahead of print]
设计、研究单位和患者：年龄<14岁的慢性咳嗽患儿入选本研究。这些患儿怀疑存在返酸，考虑采用pH－咳嗽记录器进行非卧床式监测，该记录器能同时以较快的速度（10 Hz）同时监测咳嗽和pH值。
主要监测指标：返酸期间（pH<4持续>0.5 s）10 s、30 s、60 s及120 s内咳嗽次数。结果：20名儿童中共记录到5628次咳嗽。大部分咳嗽（83.9%）不依赖于返酸。120 s内出现咳嗽－反流（中位数19，IQR 3-45）和反流－咳嗽（24.5, 13-51）的频率相当。在10 s 和30 s 内，反流－咳嗽（10 s：中位数：2.5, IQR：0-7.25；30 s：6.5, 1.25-22.25）频率显著少于咳嗽－反流频率（10 s：27, IQR 15-65；30 s=24.5, 14.5-55.5）（P分别为0.0001和0.001）。60 s和120 s内未见显著差异。 10 s内咳嗽－反流频率（中位数1.0, IQR 0-8）显著少于30 s (P=0.006)和60 s (P=0.048)内非咳嗽－反流（中位数29.5, 15-67），而非120 s内非咳嗽－反流频率（P=0.47）。
结论：对于可能存在胃食管反流疾病的慢性咳嗽儿童，返酸和咳嗽存在的时间相关性不存在因果关系。
（陈欣 审校）
Arch Dis Child. 2010 Jun 1. [Epub ahead of print]
An objective study of acid reflux and cough in children using an ambulatory pHmetry-cough logger.
Chang AB, Connor FL, Petsky HL, Eastburn MM, Lewindon PJ, Hall C, Wilson SJ, Katelaris PH.
Queensland Children’s Respiratory Centre and Queensland Children’s Medical Research Institute, Royal Children’s Hospital, Brisbane, Australia.
Abstract
Objective There are no objective ambulatory studies on the temporal relationship between reflux and cough in children. Commercial pHmetry loggers have slow capture rates (0.25 Hz) that limit objective quantification of reflux and cough. The authors aimed to evaluate if there is a temporal association between cough and acid pH in ambulatory children with chronic cough. Design, setting and patients The authors studied children (aged <14 years) with chronic cough, suspected of acid reflux and considered for pHmetry using a specifically built ambulatory pHmetry-cough logger that enabled the simultaneous ambulatory recording of cough and pH with a fast (10 Hz) capture rate. Main outcome measures Coughs within (before and after) 10, 30, 60 and 120 s of a reflux episode (pH<4 for >0.5 s). Results Analysis of 5628 coughs in 20 children. Most coughs (83.9%) were independent of a reflux event. Cough-reflux (median 19, IQR 3-45) and reflux-cough (24.5, 13-51) sequences were equally likely to occur within 120 s. Within the 10 and 30 s time frame, reflux-cough (10 s=median 2.5, IQR 0-7.25; 30 s=6.5, 1.25-22.25) sequences were significantly less frequent than reflux-no cough (10 s=27, IQR 15-65; 30 s=24.5, 14.5-55.5) sequences, (p=0.0001 and p=0.001, respectively). No differences were found for 60 and 120 s time frame. Cough-reflux sequence (median 1.0, IQR 0-8) within 10 s was significantly less (p=0.0001) than no cough-reflux sequences (median 29.5, 15-67), within 30 s (p=0.006) and 60 s (p=0.048) but not within 120 s (p=0.47). Conclusions In children with chronic cough and suspected of having gastro-oesophageal reflux disease, the temporal relationship between acid reflux and cough is unlikely causal.
Arch Dis Child. 2010 Jun 1. [Epub ahead of print]
上一篇：
非卧床式咳嗽监测和主动咳嗽计数在不同环境下的有效性
下一篇：
检测咳嗽严重程度：一项新型、包含7项目的咳嗽严重程度患者主诉结果检测方法的开发和初步研究
