目的探讨24 h食管pH监测在婴儿喘息性疾病中的应用。方法对74例喘息性疾病婴儿进行24 h食管pH监测,监测指标包括食管pH<4.00的次数、反流时间≥5 min的次数、最长反流时间、卧位pH<4.00的时间占总监测时间的百分比以及Biox-Ochoa评分;对所有喘息患儿按照病情分为持续性喘息组和一般喘息组,比较2组24 h食管pH监测情况;将其中有病理性胃食管反流(GER)的40例患儿随机分为治疗组和对照组。对照组给予常规抗炎、平喘治疗,治疗组在抗炎、平喘治疗基础上加用抗GER治疗。比较2组患儿住院时间和肺部啰音消失时间?峁?4例喘息性疾病患儿病理性GER发生率为54.0%。其中持续性喘息组病理性GER发生率(69.4%),显著高于一般喘息组(39.5%);持续性喘息组各项反流指标均高于一般喘息组(Pa<0.01)。治疗组患儿住院时间、肺部啰音消失时间均较对照组明显缩短,差异均有统计学意义(Pa<0.01)。所有患儿在24 h食管pH监测中未出现严重不良反应,无终止监测的发生。结论喘息性疾病患儿病理性GER发生率高,持续性喘息患儿发生率更高。伴有病理性GER的喘息患儿经抗GER治疗后效果明显。24 h食管pH监测安全,对婴儿喘息性疾病的诊断及指导治疗有重要价值。 Objective To investigate the application of 24-h esophageal pH monitoring in infantile wheezing diseases. Methods 24-hour esophageal pH monitoring was performed in 74 infants with wheezing diseases. The monitoring indicators included the number of esophageal pH <4.00, the number of reflux times ≥ 5 min, the longest reflux time, the time of lying pH <4.00, The percentage of time, and the Biox-Ochoa score. All patients with wheezing were divided into two groups according to the condition: persistent wheezing group and general wheezing group. The 24-hour esophageal pH monitoring was compared between the two groups. Pathological gastroesophageal reflux (GER) Forty children were randomly divided into treatment group and control group. The control group was given conventional anti-inflammatory and antiasthmatic treatment. The treatment group was given anti-GER treatment on the basis of anti-inflammatory and anti-asthmatic treatment. The hospitalization time and pulmonary rales disappear time were compared in two groups. The incidence of pathological GER in 4 cases of asthmatic children was 54.0%. Among them, the incidence of pathological GER in persistent wheezing group was significantly higher than that in general wheezing group (69.4% vs 39.5%, P <0.01). The hospitalization time and the disappearance of pulmonary rales in the treatment group were significantly shorter than those in the control group (P <0.01). No serious adverse reactions were observed in 24 h esophageal pH monitoring in all children, with no termination monitoring. Conclusion The incidence of pathological GER in children with wheezing diseases is high, and the incidence of persistent wheezing is higher. Asthmatic children with wheezing associated with pathological GER have a significant effect after anti-GER treatment. 24 h esophageal pH monitoring safety, diagnosis and treatment of infantile asthmatic disease has important value.