窒息新生儿胃运动及影响因素的研究

Study on Gastric Activity and Influential Factors in Term Newborn Infants with Asphyxia

目的 研究窒息足月新生儿胃电运动、血浆胃动素及血清一氧化氮 (NO)变化规律 ,对窒息新生儿消化运动功能进行评价 ,为探讨有效的干预对策提供理论依据。方法 对足月窒息新生儿 2 9例餐后体表胃电图、血浆胃动素、血清NO进行检测 ,并以正常新生儿做对照。结果 窒息组正常胃慢波百分比 (PNSW )明显低于对照组 ,分别为 (3 5 .3 5± 2 2 .5 1) %与 (4 9.78±18.80 ) % ,两组比较P <0 .0 5 ,而异常慢波百分比 (PUSW)却明显高于对照组 ,分别为 (5 5 .66± 2 9.3 9) %与 (3 1.99± 13 .79) % ,两组比较P <0 .0 1。PNSW轻度窒息组明显高于重度窒息组 (P <0 .0 5 )。窒息组和对照组餐后血浆胃动素分别为 (3 0 1.47± 73 .3 1)ng/L和 (4 3 6.5 8± 185 .5 7)ng/L ,窒息组明显低于对照组 (P <0 .0 0 1)。窒息组餐后血清NO为 (110 .61± 13 .75 ) μmol/L ,对照组为(98.66± 0 .72 ) μmol/L ,窒息组明显高于对照组 (P <0 .0 1)。窒息组异常PUSW与血浆胃动素呈显著负相关 (P <0 .0 0 1) ;PUSW与血清NO呈显著正相关 (P <0 .0 1) ;血浆胃动素与血清NO呈显著负相关 (P <0 .0 1)。结论 窒息新生儿存在胃电基本节律紊乱、胃动素水平降低和NO水平升高 ,提示窒息后新生儿的胃肠动力障碍与神经体液调节异常有关。

Objective To study the changable regularity in term newborns with birth asphyxia on gastri c myoelectrical activity and plasma motilin and serum nitric oxide(NO) concentration and to evaluate digestive motor function on newb orns with birth asphyxia and investigate the effective intervening countermeasur e. Methods Measured electrogastrography (EGG),plasma motilin and serum NO concentration in 29 term newborns with birth asphyxia after feedings,as compared with those of no rmal controls. Results The percentage of normal slow wave(PNSW) in the asphyxia group (35.35±22.511)% was significantly lower than that in the healthy subjects(49.78±18.80)%(P<0 .05),but the percentage of unnormal slow wave(PUSW) was significantly increased as compared with normal controls,was separately(55.66±29.39)%,(31.99±13.79)%( P<0.01).PNSW was significantly increased in the light asphyxia than that in the severe asphyxia (P<0.05).The concentration of motilin was significantly lower in the asphyxia than that in controls, were separately(301.47±73.31)ng/ L,(436.58±185.57)g/L(P<0.001),but the level of NO was enhanced in asphyxi a, there was signi- ficantly difference in both groups(110.61±13.75)μmol /L,(98.66±0.72)μmol/L (P<0.01).Related analysis of experimental para- meter in the asphyxia group showed that there was prominently negative correla tion between the PUSW and the level of plasma motilin(P<0.001),there was sig nificantly positive correlation between the PUSW and the concentration of serum NO(P<0.01),there was notable negative correlation between the level of motil in and NO(P<0.01). Conclusion Asphyxia newborns exist disordered of electrogastrography rhyme,motilin is low er and NO is enhanced,suggest some gastrointestinal symptoms in neonates with bi rth asphyxia may be relationship with unusual regulation of the nerve and body f luid. J Appl Clin Pediatr,2005,20(2):131-133