Pediatrics：GERD疾病标签或致婴儿过度治疗

　　美国一项研究表明，胃食管反流病（GERD）标签可能导致父母对婴儿进行过度药物治疗。论文4月1日在线发表于《儿科学》（Pediatrics）。

　　该研究利用2 × 2析因设计对婴儿父母进行了临床场景模拟评估。即便被告知药物可能无效，被诊断GERD婴儿的父母仍倾向于对孩子进行药物治疗。而未被诊断GERD婴儿父母则仅在药物可能有效的情况下，接受药物治疗。

　　研究者指出， 作为医师，我们必须重视与患者家属交谈时的用辞，因为患儿父母可能将正常的过程认为是疾病。作为儿科医师，我们的工作是让患儿恢复健康，而不是让健康的婴儿患病，不必要的药物治疗，可能增加患儿肺炎发生率。

与GERD相关的拓展阅读：

• J. Clin. Gastroenterol：BMI不影响PPI对GERD的疗效
• Ann Surg：两种胃底折叠术缓解GERD的效果相似
• 食管下端电刺激疗法可有效治疗GERD
• J. Pediatr：牛奶激发试验或有助确诊过敏患儿的GERD 更多信息请点击：有关GERD更多资讯

Prognostic Values of Multichannel Intraluminal Impedance and pH Monitoring in Newborns with Symptoms of Gastroesophageal Reflux Disease
Objective
To evaluate the relationship between multichannel intraluminal impedance and pH monitoring (MII/pH) values in newborns with symptoms of gastroesophageal reflux disease (GERD) and clinical history in their first 3 years of life.
Study design
Sixty-four newborns with GERD symptoms who underwent MII/pH in the first weeks of life were enrolled into a clinical follow-up program. Follow-up visits were programmed at 1, 3, 6, 9, 12, 18, 24, and 36 months. Patients were divided into 3 groups according to duration of symptoms: short (1-3 months), medium (4-9 months), and long (>9 months), and MII/pH values in these groups were compared.
Results
Fifty-three patients completed the 3-year follow-up. The number of patients with GERD symptoms decreased each month. A comparison of MII/pH values of the 3 lifetime symptom groups revealed differences in the impedance bolus exposure index (F = 83; P = .012) and proximal reflux frequency (F = 410; P = .022). These 2 MII variables showed an increasing trend from the short lifetime symptom group to the long lifetime symptom group. Weakly acidic reflux events, but not acidic events, were responsible for these differences.
Conclusion
MII/pH in newborns has prognostic value regarding the duration of GERD symptoms and provides useful information that clinicians may give parents about the prognosis of symptomatic infants. Impedance bolus exposure index and proximal reflux frequency seem to be the variables with the highest predictive value. Weakly acidic reflux events play an important role in determining the duration of GERD symptoms in newborns.