目的

探讨以慢性咳嗽为表现的胃食管反流病（GERD）患儿的胃超声造影及肠道菌群特征。

方法

回顾性选取2022 年4 月至2024 年4 月在唐山市妇幼保健院就诊慢性咳嗽患儿258例，均行胃超声造影检查，将158 例GERD 患儿作为研究组病情严重程度根据DeMeester 积分将其分为轻中度组（n=106）、重度组（n=52），同时选取无GERD 患儿100 例作为对照组。比较各组His 角、腹段食管长度、肠道菌群变化，采用Spearman 秩相关分析法分析慢性咳嗽为表现的GERD患儿胃超声造影及肠道菌群特征与病情程度的相关性。

结果

研究组患儿His 角大于对照组，腹段食管长度短于对照组，肠球菌、大肠杆菌水平明显高于对照组，乳酸菌、双歧杆菌水平明显低于对照组（P 均＜0.05）；重度组患儿His 角大于轻中度组，腹段食管长度短于轻中度组，肠球菌、大肠杆菌水平明显高于对照组，乳酸菌、双歧杆菌水平明显低于轻中度组（P 均＜0.05）；经Spearman秩相关分析显示，慢性咳嗽为表现的GERD 患儿His 角、肠球菌、大肠杆菌与病情严重程度呈正相关，腹段食管长度、乳酸菌、双歧杆菌与病情严重程度呈负相关（P＜0.05）。

结论

慢性咳嗽表现的GERD 患儿中，His 角增大、腹段食管缩短以及肠道菌群失衡均与病情的严重程度相关，这些指标可为临床干预提供重要参考。

Objective

To investigate the characteristics of gastric contrast-enhanced ultrasound and intestinal flora in children with gastroesophageal reflux disease (GERD) manifested by chronic cough.

Methods

A retrospective selection was made of 258 children with chronic cough who visited Tangshan Maternal and Child Health Hospital from April 2022 to April 2024.All of them underwent gastric contrast-enhanced ultrasound examination, and 158 children with GERD were taken as the study group.According to DeMeester scores, the patients were divided into mild-to-moderate group (n=106) and severe group (n=52), 100 children without GERD were selected as the control group.The changes of His angle,abdominal esophageal length and intestinal flora in each group were compared, and Spearman rank correlation analysis was used to analyze the correlation between gastric contrast-enhanced ultrasound and intestinal flora characteristics and disease severity in GERD children with chronic cough.

Results

In the study group, the His angle of the children was larger than that of the control group, the length of the abdominal esophagus was shorter than that of the control group, the levels of Enterococcus and Escherichia coli were significantly higher than those of the control group, and the levels of Lactobacillus and Bifidobacterium were significantly lower than those of the control group (all P<0.05).In the severe group, the His angle of the children was larger than that of the mild-to-moderate group, the length of the abdominal esophagus was shorter than that of the mild-to-moderate group, the levels of Enterococcus and Escherichia coli were significantly higher than those of the control group, and the levels of Lactobacillus and Bifidobacterium were significantly lower than those of the mild-to-moderate group (all P<0.05).Spearman rank correlation analysis showed that His horn, Enterococcus and Escherichia coli were positively correlated with the severity of the disease in GERD children with chronic cough, while abdominal esophageal length, Lactobacillus and Bifidobacterium were negatively correlated with the severity of the disease (P<0.05).

Conclusion

Among GERD children with chronic cough, the enlargement of His angle,the shortening of the abdominal esophagus and the imbalance of intestinal flora are all correlated with the severity of the disease.These indicators can provide important references for clinical intervention.