胃肠激素检测在小于胎龄儿变化中的临床意义

Clinical Significance of Determination of Blood Gastro-intestinal Hormones Levels in Small for Gestational Age Newborns

目的:对68例小于胎龄儿(其中早产36例;足月32例)生后喂奶前及第7d空腹血中生长抑素(so-m atostatin,SS)、胃动素(motilin,MOT)、胃泌素(gastrin,Gas)浓度进行测定,并以30例足月新生儿作为对照组。方法:应用放射免疫分析测定SS、MOT、Gas浓度。结果:小于胎龄儿组生后喂奶前及第7d空腹血浆MOT、Gas均明显低于对照组,而SS浓度明显高于对照组,并且与胎龄、开始喂养时间及当日进奶等因素相关。结论:小于胎龄儿消化道机能适应胃肠道营养,在严密观察下应用合理的喂养方式早日开始胃肠道营养,将能促进小于胎龄儿胃肠道的发育和成熟。

Objective To investigate the changes of plasma motilin, plasma somatostatin and serum gastrin levels after beginning oral feeding in 68 small for gestational age neonates （pre - term 36, full - term 32）. Methods Blood levels of somatostatin （ SS）, motilin and gastrin were determined with RIA before beginning of oral feeding and on 7^th day after birth in 68 small for gestational age neonates and 30 controls. Results The blood levels of motilin and gastrin before feeding and on 7^th day in the small for gestational age neonates were significantly lower than those in the controls, while the SS levels were significantly higher. The serum levels of the hormones rose gradually after birth and on 7^th day were all significantly higher than those before feeding respectively （P 〈0.01 ）. For motilin, the 7^th day levels were positively correlated with gestational age, original levels before feeding and early feeding. For gastrin, the levels were also positively correlated with the amount of feeding. In this study, early oral feeding was practiced in all the neonates without any adverse effect. Conclusion Although the blood levels of gastro - intestinal hormones were lower in small for gestational age newborns, early oral feeding was practiced in all the neonates with no adverse effect observed and more rapid elevation of the hormone levels. Therefore, early oral feeding should be encouraged.