pH nasofar赤ngeo e refluxo gastroesof芍gico em crianˋas com doenˋa respirat車ria crˋnica

作者：Junqueira; Jose Cesar da Fonseca; Penna; Francisco Jose

来源：Jornal de Pediatria, 2007.

DOI：10.1590/S0021-75572007000400007

• gastroesophageal reflux [complications]
• gastroesophageal reflux [diagnosis]
• child
• evaluation studies
• nasopharynx
• esophageal ph monitoring.

objectives: the aim of this case-control study was to evaluate the nasopharyngeal ph (nasoph) in children with normal or abnormal ph-metry in two groups of patients: 1) children presenting gastroenterological symptoms; and 2) children with chronic respiratory symptoms. methods: from february 2004 to january 2005, all consecutive patients referred for 24-hour ph-metry and in whom gastroesophageal reflux disease was suspected were enrolled in a prospective study. they were assigned to four groups: gastroenterological symptoms with normal (a) or abnormal (b) ph-metries (gg), and chronic respiratory symptoms with normal (c) or abnormal (d) ph-metries (rg). nasoph was measured for 5 minutes, before the 24-hour test was performed. results: thirty-eight ph-metry tests were included (20 in the rg and 18 in the gg). abnormal ph-metry results were observed in 11 patients in the gg and in 12 in the rg. nasoph means were 6.3273 and 5.6917, respectively (p %26lt; 0.0001). average nasopharyngeal ph was 5.6917 among the 12 rg patients with abnormal ph-metry results and 6.5000 among the remaining eight patients with normal test results (p = 0.0006). analysis of the rg with a receiver operating characteristic (roc) curve showed ph of 5.8 as cutoff point (sensitivity of 91.7% and specificity of 87.5%). the area below the roc curve was 0.870. conclusions: nasopharyngeal ph is significantly lower among patients in the rg presenting abnormal ph-metry results. a 5.8 nasoph has good sensitivity and specificity and can be used as a screening test in patients with chronic respiratory diseases to select those for whom conventional 24-hour ph-metry is indicated.