Follow-up of a cohort of children and adolescents with gastro-esophageal reflux disease who were free of reflux esophagitis at initial diagnosis
Follow-up of a cohort of children and adolescents with gastro-esophageal reflux disease who were free of reflux esophagitis at initial diagnosis
复制标题
对初次诊断时未患反流性食管炎的胃食管反流病儿童和青少年队列进行随访
DOI：
10.3109/00365521003793758
复制
发表时间：
2010
影响因子：
1.9
通讯作者：
L. G. García Rodríguez
中科院分区：
文献类型：
--
作者：
A. Ruigómez;P. Lundborg;S. Johansson;M. Wallander;L. G. García Rodríguez
抽象目标。很少有研究调查了初级保健中儿童和青少年胃食管反流病（GERD）并发症的发生率。在此，我们的目的是描述GERD的自然史在儿科人群中没有反流性食管炎在初步诊断，评估诊断新的食管并发症和食管外条件。材料和方法。我们使用英国健康改善网络初级保健数据库（其中包括超过200万例患者的数据），通过计算机搜索，然后对患者记录进行手动审查，确定2000-2005年期间首次诊断为胃食管反流或胃灼热的1-17岁的个体。该检索确定了1242例GERD事件诊断但无食管炎记录的个体。对该队列进行随访，以检测食管并发症和食管外疾病的新诊断。结果在平均近4年的随访期间，40名儿童和青少年确诊为反流性食管炎（发病率：10.9/1000人-年）。未报告Barrett食管、食管狭窄或食管溃疡病例。与未诊断为GERD的儿童和青少年相比，GERD患者发生食管外疾病（如哮喘、肺炎、咳嗽或胸痛）的风险增加一倍。结论.患有GERD的儿童和青少年可能有发生反流性食管炎和一系列其他食管外疾病的风险，但更严重的食管并发症很少见。
Abstract Objective. Few studies have examined the incidence of complications from gastro-esophageal reflux disease (GERD) in children and adolescents in primary care. Here we aimed to describe the natural history of GERD in a pediatric population with no reflux esophagitis at initial diagnosis, assessing diagnoses of new esophageal complications and extra-esophageal conditions. Material and methods. We used The Health Improvement Network UK primary care database (which includes data on more than 2 million patients) to identify individuals aged 1–17 years with a first diagnosis of gastro-esophageal reflux or heartburn in the period 2000–2005, via a computerized search followed by a manual review of the patient records. This search identified 1242 individuals with an incident diagnosis of GERD but no record of esophagitis. This cohort was followed-up to detect new diagnoses of esophageal complications and extra-esophageal conditions. Results. During a mean follow-up period of almost 4 years, 40 children and adolescents had a confirmed new diagnosis of reflux esophagitis (incidence: 10.9 per 1000 person-years). No cases of Barrett's esophagus, esophageal stricture or esophageal ulcer were reported. Individuals with GERD had double the risk of an extra-esophageal condition such as asthma, pneumonia, cough or chest pain compared with children and adolescents with no diagnosis of GERD. Conclusions. Children and adolescents with GERD may be at risk of developing reflux esophagitis and a range of other extra-esophageal conditions, but more severe esophageal complications are rare.