儿童胃食管反流病发病的影响因素分析

Related factors of gastroesophageal reflux disease in children

目的探讨儿童胃食管反流病(GERD)发病的影响因素。方法该研究为横断面研究。选取2015年1月至2020年12月在首都儿科研究所附属儿童医院行24 h多通道腔内阻抗-pH监测(24 h MII-pH)的370例患儿的病例资料,根据24 h MII-pH结果,将患儿分为GERD组(202例)和非GERD组(168例)。以性别、年龄、体重指数(BMI)、病程、血嗜酸粒细胞计数、血IgE、幽门螺杆菌感染、食管裂孔疝等8项指标作为发生GERD可能的因素,采用单因素和多因素logistic回归分析方法分析儿童GERD发病的影响因素。结果370例患儿中,GERD组男124例,女78例,年龄(6.4±4.1)岁(2月龄至16岁9个月),非GERD组男82例,女86例,年龄(8.0±3.5)岁(10月龄至15岁2个月)。单因素logistic回归分析显示,性别(OR=0.600,95%CI:0.396~0.908,P=0.016)、年龄(OR=0.537,95%CI:0.412~0.699,P<0.001)、食管裂孔疝病史(OR=7.433,95%CI:2.567~21.520,P<0.001)与儿童GERD发病有关。多因素logistic回归分析显示,男童(OR=0.567,95%CI:0.367~0.874,P=0.010)、低龄(OR=0.613,95%CI:0.459~0.819,P=0.001)、食管裂孔疝病史(OR=4.023,95%CI:1.298~12.470,P=0.016)是儿童GERD发病的影响因素。结论男童、低龄,合并食管裂孔疝是儿童GERD发病的影响因素。

Objective To investigate the factors related to gastroesophageal reflux disease(GERD)in children.Methods Clinical data of 370 children who underwent 24h multi-channel impedance-pH monitoring(24h MII-pH)in Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2015 to December 2020 were enrolled in the study.The children were divided into GERD group(n=202)and non-GERD group(n=168)according to results of 24h MII-pH.The relationship of sex,age,body mass index(BMI),disease course,peripheral blood eosinophils count,IgE,Helicobacter pylori(Hp)infection,hiatus hernia of patients with GERD was analyzed by univariate and multivariate logistic regression analysis.Results In GERD group 124 were males and 78 were females with a mean age of(6.4±4.1)years(2 months to 16.75 years),and in non-GERD group 82 were males and 86 were females with a mean age of(8.0±3.5)years(10 months to 15.17 years).Univariate logistic regression analysis showed that sex(OR=0.600,95%CI:0.396-0.908,P=0.016),age(OR=0.537,95%CI:0.412-0.699,P<0.001)and hiatus hernia(OR=7.433,95%CI:2.567-21.520,P<0.001)were significantly associated with GERD of the children.Multivariate analysis showed that hiatus hernia(OR=4.023,95%CI:1.298-12.470,P=0.016)was the independent risk factor,while male gender(OR=0.567,95%CI:0.367-0.874,P=0.010)and younger age(OR=0.613,95%CI:0.459-0.819,P=0.001)were related factors of gastroesophageal reflux disease in children.Conclusion Sex,age,and hiatal hernia are factors related to GERD in children.