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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Gastroesophageal reflux and asthma in children: a systematic review.
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Gastroesophageal reflux and asthma in children: a systematic review.

机译：儿童胃食管反流和哮喘：系统评价。

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CONTEXT: The relationship between gastroesophageal reflux disease (GERD) and asthma in children has been investigated; however, the nature of the association (if any) between these 2 conditions is unclear. OBJECTIVE: We performed a systematic review of the literature to examine the association between GERD and asthma in children. METHODS: A search of the medical literature was conducted by using PubMed and Embase (1966 through December 2008). Full-length articles in English that described at least 20 subjects younger than 18 years were included if they reported the prevalence of GERD (symptoms, pH studies, endoscopy/histology) in individuals with asthma or the prevalence of asthma in individuals with GERD. We calculated pooled odds ratios from studies that examined control groups, and we pooled prevalence estimates from all studies. RESULTS: A total of 20 articles that described 5706 patients fulfilled the inclusion and exclusion criteria. Seventeen studies used objective methods for documenting reflux (eg, pH probe, contrast imaging, impedance, esophagogastroduodenoscopy), 2 studies relied on symptom-based questionnaires, and 1 study used diagnostic codes. Most studies (n = 19) examined the prevalence of GERD in 3726 individuals with asthma and reported highly variable estimates (19.3%-80.0%) and a pooled average of 22.8% with GERD symptoms, 62.9% of 789 patients with abnormal esophageal pH, and 34.8% of 89 patients with esophagitis. Only 5 studies included controls and enrolled 1314 case-patients with asthma and 2434 controls without asthma. The average prevalence of GERD was 22.0% in asthma cases and 4.8% in controls (pooled odds ratio: 5.6 [95% confidence interval: 4.3-6.9]). CONCLUSIONS: There is a possible association between GERD and asthma in pediatric patients seen with asthma in referral settings. However, because of methodologic limitations of existing studies, the paucity of population-based studies, and a lack of longitudinal studies, several aspects of this association are unclear.
机译：背景：研究了儿童胃食管反流病（GERD）与哮喘之间的关系。但是，这两个条件之间的关联性质（如果有）尚不清楚。目的：我们对文献进行了系统的综述，以探讨儿童GERD与哮喘之间的关系。方法：使用PubMed和Embase（1966年至2008年12月）进行医学文献检索。如果报道了哮喘患者中GERD的患病率（症状，pH研究，内窥镜检查/组织学）或GERD患者中的哮喘患病率，则包括描述至少20名18岁以下受试者的英文全文文章。我们计算了检查对照组的研究的合并比值比，并合并了所有研究的患病率估计值。结果：共有20篇文章描述5706例患者符合纳入和排除标准。十七项研究使用客观方法来记录反流（例如，pH探头，对比成像，阻抗，食管胃十二指肠镜检查），两项研究基于症状问卷，而一项研究使用诊断代码。大多数研究（n = 19）在3726例哮喘患者中检查了GERD的患病率，并报告了高度可变的估计值（19.3％-80.0％），合并平均有22.8％的人患有GERD症状，在789例食管pH异常患者中占62.9％，在89例食管炎患者中占34.8％。只有5项研究纳入了对照，招募了1314例哮喘患者和2434例无哮喘患者。在哮喘患者中，GERD的平均患病率为22.0％，在对照组中为4.8％（合并优势比：5.6 [95％置信区间：4.3-6.9]）。结论在转诊的小儿哮喘患者中，GERD与哮喘之间可能存在关联。但是，由于现有研究的方法学局限性，基于人群的研究较少以及缺乏纵向研究，这种关联的几个方面尚不清楚。

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