Esophageal chest pain in children with asthma.
Esophageal chest pain in children with asthma.
复制标题
哮喘儿童的食管胸痛。
DOI：
10.1097/00005176-199101000-00011
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发表时间：
1991
影响因子：
2.9
通讯作者：
Newman,LJ
中科院分区：
文献类型：
--
作者：
Berezin,S;Medow,MS;Glassman,MS;Newman,LJ
16例哮喘和胸痛持续时间> 2个月的患者接受了使用光纤食管胃内窥镜（EGD）、食管测压和伯恩斯坦试验的胃肠病学评价。16例患者中有11例（75%）有食管炎的内镜和组织学证据。1例食管炎患者在运动试验期间表现出高振幅蠕动收缩。这11例患者中有4例（36%）伯恩斯坦试验阳性。7例食管炎患者的食管内pH监测显示，所有这些患者均存在显著的胃食管反流（格尔）。胸痛与3例患者（43%）的格尔发作相关。11例食管炎患者中有9例（82%）对药物治疗有反应，导致食管炎症和胸痛消退。1例患者在药物治疗失败后需要Nissen胃底折叠术，1例拒绝手术的患者在9个月的药物治疗期间逐渐发展为更严重的食管炎。哮喘儿童可能会因胃食管反流相关食管炎而出现胸痛，通常对药物治疗有反应。
Sixteen patients with asthma and chest pain of> 2 months duration underwent gastroenterological evaluation utilizing fiber-optic esophagogastroduodenoscopy (EGD), esophageal manometry, and Bernstein testing. Eleven of 16 patients (75%) had endoscopic and histologic evidence of esophagitis. One patient with esophagitis exhibited high-amplitude peristaltic contractions during motility testing. Four of these 11 patients (36%) had a positive Bernstein test. Extended intraesophageal pH monitoring of seven patients with esophagitis revealed significant gastroesophageal reflux (GER) in all of these patients. Chest pain was associated with an episode of GER in three patients (43%). Nine of 11 patients (82%) with esophagitis responded to medical therapy, resulting in resolution of esophageal inflammation and chest pain. One patient required Nissen fundoplication surgery after failure of medical therapy, and one patient who refused surgery progressively developed more severe esophagitis during 9 months of medical therapy. Children with asthma may have chest pain due to gastroesophageal reflux-associated esophagitis that usually responds to medical therapy.