Objective To investigate the relationship between laryngopharyngeal reflux diseases and persistent wheezing in infants and young children, and develop a new method for the diagnosis and therapy of persistent wheezing.
Methods Total 60 infants suffering from persistent wheezing more than one month without remission after Pulmicort inhalation therapy in clinic were admitted. There were 45 males and 15 females, with a mean age of (9.93±0.82) months. The fiberoptic bronchoscopy and 24-hour laryngopharynx pH monitoring were performed in all patients. According to laryngopharyngeal reflux criteria, the infants were divided into the laryngopharyngeal reflux group and the non-reflux group, meanwhile, according to trachea under the bronchoscope, the patients were also divided into the tracheomalacia group and the non-tracheomalacia group.
Results ①Bronchoscopy examination showed that all patients had endobronchial inflammation. The mean age of 22 cases of tracheobronchomalacia (tracheomalacia group) was (8.13±5.65) months, and of 38 cases of non-tracheobronchomalacia (non-tracheomalacia group) was (10.92±5.59) months, there was no significant difference in age of patients between the two group. ②According to the index of Ryan, 36 cases were with laryngopharyngeal reflux, and the incidence rate of laryngopharyngeal reflux was 60%. ③In the Tracheomalacia group, Ryan index was in the upright position (197.67±228.19), which was significantly higher than that of non-tracheomalacia group (33.76±49.64), the difference was statistically significant (
t=3.324,
P=0.003). ④ There were 38 patients meeting the diagnostic criteria of laryngopharyngeal reflux (18 cases in each group) with the incidence of 81.8% and 47.4%, respectively, the difference was significant m (χ
2=6.890,
P=0.009).
Conclusion Laryngopharyngeal reflux is an important cause of persistent wheezing in infants and children. The incidence of laryngopharyngeal reflux is higher in children with persistent tracheomalacia.
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