危重症患儿血清促胃液素、血浆胃动素和生长抑素水平变化及其临床意义

Changes of Serum Gastrin,Plasma Motilin and Somatostatin in Critically Ill Children and Those Clinical Significances

目的探讨血清促胃液素（GAS）、血浆胃动素（MTL）和生长抑素（SST）水平在危重症及并胃肠功能障碍（GID）患儿的变化，并探讨其临床意义。方法根据小儿危重病例评分法将75例患儿分为极危重组（评分〈70分）、危重组（评分70～90分）、非危重组（评分〉90分）；根据其有无并发GID，将危重和极危重组患儿50例分为GID组和无GID组。采用放射免疫分析方法检测其急性期、恢复期空腹血清GAS、血浆MTL和SST水平，与25例健康对照组儿童清晨空腹血清GAS、血浆MTL和SST水平比较，分析其血清GAS、血浆MTL和SST水平与病情危重程度、GID的关系。应用SPSS11．5软件进行多组间单因素方差分析和组间t检验。结果极危重和危重组患儿急性期血清GAS和血浆MTL水平较对照组升高，血浆SST水平较对照组下降，且病情越重，GAS、MTL水平越高，SST水平越低；恢复期GAS、MTL水平较急性期下降，SST水平较急性期升高；并发GID者血清GAS、血浆MTL水平高于未并发GID者，而血浆SST水平低于未并发GID者。结论GAS、MTL和SST在GID的发生发展中起重要作用。危重症患儿血清GAS、血浆MTL和SST水平可作为评估病情严重程度、判断预后的指标之一。

Objective To explore the changes of serum gastrin （GAS）, plasma motilin （MTL） and somatostatin （SST） in critically ill children with gastrointestinal dysfunction （GID）. Methods According to pediatric critical illness score, 75 cases were divided into greatly critical group （ score 〈 70 ）, critical group （ scorce 70 - 90 ） and non - critical group （ score 〉 90 ）. Fifty cases of greatly critical and critical group were divided into GID group and non - GID group. The levels of serum GAS, plasma MTL and SST were detected on an empty stomach at acute stage and convalescence stage, comparing with those of normal control group, and then ,the relationship between the levels of serum GAS, plasma MTL,SST and GID ,the severity of disease were analyzed. Results At acute stage ,the levels of serum GAS and plasma MTL of greatly critical group and critical group were higher than those of normal control group, the levels of plasma SST of greatly critical group and critical group were lower than that of normal control group,the more severe condition of critical children,the higher level of serum GAS and plasma MTL,the lower level of plasma SST. At convalescence stage ,the level of serum GAS and plasma MTL of the greatly critical group and critical group decreased and the level of plasma SST increased. The levels of serum GAS and plasma MTL of GID group were higher than those of non - GID group, but the level of plasma SST of GID group was lower than that of non - GID group. Conclusion The level of serum GAS, plasma MTL and SST can be used to assess the severity of illness and prognosis,judge the change of disease and determine the efficacy of treatment programs ,and detect gastrointestinal functional lesion.