多器官功能障碍综合征危重患儿血促胃液素、胃动素及胰岛素生长因子水平变化

Changes of Blood Levels of Gastrin,Motilin and Insulinoid Growth Factor-1 in Critical Children with Multiple Organ Dysfunction Syndrome

目的对危重患儿多器官功能障碍(MODS)时血促胃液素(GAS)、胃动素(MTL)及胰岛素样生长因子-1(IGF-1)进行检测,探讨其水平变化与器官功能障碍或衰竭的关系。方法采用放射免疫法对危重患儿50例及非危重患儿30例血GAS、MTL及IGF-1进行检测,并与30例正常对照组进行比较。结果危重患儿血GAS、MTL及IGF-1各组均数差异有显著性(F=49.61,55.18,18.23 P均<0.001),胃肠功能障碍组血GAS、MTL及IGF-1水平变化与非胃肠功能障碍组比较差异有显著性(t=4.455、4.241、2.672 P均<0.001)。危重患儿器官功能障碍中4个器官功能障碍与2个器官功能障碍比较,MTL与IGF-1差异有显著性,GAS差异无显著性。危重患儿治疗前后血GAS、MTL及IGF-1水平及非危重组与正常对照组比较差异有显著性(t=3.232、4.352、4.706 P均<0.001)。结论危重患儿MODS时血GAS、MTL及IGF-1可能参与危重症病情的发展,且与胃肠功能障碍及MODS发生有关,结合患儿临床对其血GAS、MTL及IGF-1进行监测,对估计患儿病情严重程度及治疗有重要指导意义。

Objective To investigate the changes of blood levels of gastrin（GAS）, motilin （MTL） and insulinoid growth factor - 1 （IGF - 1） in critical children with multiple organ disfunction syndrome （MODS）. Methods The levels of GAS, MTL and IGF - 1 in 50 critically ill children and 30 children without critical illness were detected. The control group consisted of 30 healthy children. All serum or plasma levels of GAS, MTL and IGF - 1 were measured by radioimmunoassay. Results The serum or plasma levels of GAS, MTL and IGF - 1 were significantly higher in critically ill children than those in uncritically ill children and control group （F = 49.61, 55.18, 18.23 all P 〈 0.001）. The levds of GAS, MTL and IGF - 1 in gastrointestinal dysfunction group were higher than those of children without gastrointestinal dysfunction group （t = 4.455, 4.241, 2.672 all P 〈 0.001）. Compared with 2 organs dysfunction in critically ill children, the levels of MTL and IGF - 1 were significantly higher in 4 organs dysfunction in critically ill children. However, there were no significant difference in plasma levels of GAS. Significant decrease of serum or plasma levels of GAS, MTL and IGF - 1 were observed in critically ill children after therapy （t = 3.232, 4.352, 4.706 all P 〈 0.001）. Conclusions The serum or plasma of GAS, MTL and IGF - 1 were heavily involved in development of critical, and related to onset of gastrointestinal dysfunction end MODS. So, monitoring GAS, MTL and IGF - 1 might have guiding value on assessment of severity of benefit for treatment.