重及特重度烧伤早期血胃泌素、胃动素和β内啡肽的测定及其意义

Measurements and significance of serum gastrin, plasma motilin and serum beta-endorphin in patients with severe burns

目的探讨重度及特重度烧伤后早期血清胃泌素、β内啡肽及血浆胃动素浓度的动态变化并分析其意义。方法以重及特重度烧伤住院患者32例为对象,分时段采血,放免检测血清胃泌素、β内啡肽和血浆胃动素浓度。结果重度及特重度烧伤后早期胃泌素明显降低,伤后8h一直在最低水平,但在9～24h段有一个高峰,后微下降至一相对稳定水平;胃动素在伤后2h为最高值,后在休克期内一直为低值,在伤后8h为最低,进入回吸期稳定上升,但仍低于正常;β内啡肽在伤后早期即升高,伤后8h最高。烧伤面积越大,胃泌素、胃动素降低越明显,β内啡肽升高越显著;但在超过70%面积时即没有相对应关系。结论重度及特重度烧伤后早期血清胃泌素、β内啡肽及血浆胃动素浓度的动态变化有一定规律性,疼痛应激,休克对其有明显影响。

Objective To investigate the changes and significance of serum gastrin (GAS), beta-endorphin (beta-EP) and plasma motilin(MTL) in patients with severe burns. Methods Blood samples were gotten according to different timepoints from 32 admitted burned patients, and then serum GAS, beta-EP and plasma MTL were determined by radio-immuno assay ( RIA ). Results In patients with severe burns, serum GAS decreased significantly in early period. And at the timepoint of 8 h, it reached the lowest level. But during 9—24 h it elevated for a while, and then it reached a relatively stable level. MTL reached the highest level at the timepoint of 2 h after burning. Then at the shock stage, it was comparatively lower. And at the timepoint of 8 h after burning, it reached the lowest level, then raised persistently after reabsorption, but still lower than the normal level. At the early stage after burning, beta-EP raised, then reached the highest level at 8 h after burning. GAS and MTL decreased and beta-EP increased significantly with the increase of the burned area. However, when the burned area was over 70% of the total body surface area, there was no relationship between them. Conclusion Blood GAS, MTL and beta-EP have represented regular changes in patients with severe burns at the early stage after burning. And the pain-stimulus and shock are effective factors.