Gastroesophageal reflux disease in children and adolescents in primary care
Gastroesophageal reflux disease in children and adolescents in primary care
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DOI：
10.3109/00365520903428606
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发表时间：
2010-01-01
影响因子：
1.9
通讯作者：
Garcia Rodriguez, Luis A.
中科院分区：
文献类型：
--
作者：
Ruigomez, Ana;Wallander, Mari-Ann;Garcia Rodriguez, Luis A.
目标。目的：确定在英国初级保健中心的儿童和青少年中被诊断为胃食道反流病(GERD)的患病率和发病率，并评估与GERD诊断相关的合并症。材料和方法。通过计算机搜索GERD的诊断代码，然后手动审查患者记录，从健康改善网络(Thin)英国初级保健数据库中识别2000-05年间的GERD事件病例。结果。我们在2000-05年间发现了1700名首次诊断为GERD的儿童。GERD发病率为0.84/1000人年。发病率从1岁儿童的1.48/1000人年下降到12岁，16-17岁时最高，女孩为2.26/1000人年，男孩为1.75/1000人年。怀孕的青少年不包括在这项研究中。除了典型的GERD症状(上腹痛、烧心、反流、反流)外，21.2%的儿童报告有恶心或呕吐。患有神经疾病的儿童被诊断为GERD的风险增加。裂孔疝气和先天性食道疾病也与胃肠道反流病的诊断有关。使用抗癫痫药、口服/吸入类固醇、β-激动剂和扑热息痛的儿童和青少年患GERD的风险增加。结论。GERD诊断的发生率与年龄有关，在非常年幼的儿童和年龄较大的女性青少年中最高。患有神经损伤和其他合并症的儿童患GERD的风险更高。
Objectives. To determine the prevalence and incidence of a diagnosis of gastroesophageal reflux disease (GERD) in children and adolescents in UK primary care, and to assess comorbidities that are associated with a diagnosis of GERD. Material and methods. Incident GERD cases during 2000-05 were identified from The Health Improvement Network (THIN) UK primary care database via a computer search for diagnostic codes for GERD, followed by manual review of the patient records. Results. We identified 1700 children with a first diagnosis of GERD during 2000-05. The incidence of GERD was 0.84 per 1000 person-years. The incidence decreased with age from 1.48 per 1000 person-years among 1-year-old children until the age of 12 years, whereupon it increased to a maximum at 16-17 years of 2.26 per 1000 person-years for girls and 1.75 per 1000 person-years for boys. Pregnant adolescents were not included in the study. In addition to typical GERD symptoms (epigastric pain, heartburn, reflux, regurgitation), 21.2% of children reported nausea or vomiting. Children with neurological disorders were at increased risk of a GERD diagnosis. Hiatus hernia and congenital esophageal disorders were also associated with a diagnosis of GERD. Children and adolescents using antiepileptics, oral/inhaled steroids, beta-agonists and paracetamol had an increased risk of a GERD diagnosis. Conclusions. The incidence of a GERD diagnosis was age-dependent and was highest among very young children and older female adolescents. Children with neurological impairments and other comorbidities were at increased risk of a GERD diagnosis.