重症监护室患儿血清胃泌素和胃动素指标的变化及意义研究

Changes and Significance of Serum Gastrin and Motilin in the Blood of Children in Pediatric Intensive Care Unit

背景血清胃泌素(GAS)、胃动素(MTL)对胃肠运动功能具有重要的调节作用。危重症患儿发生胃肠功能障碍或胃肠功能衰竭是应激后多脏器功能衰竭的诱因,因而监测血清GAS、MTL的水平具有重要意义。目的探讨重症监护室患儿血清GAS、MTL的变化及其临床监测意义。方法选取2018年1月至2019年9月萍乡市妇幼保健院儿童重症监护室300例住院患儿。采用放射免疫法测定患儿血清GAS、MTL水平。比较治疗前后不同病情严重程度、治疗前不同疾病类型、治疗前不同胃肠功能状态患儿血清GAS、MTL水平。结果治疗前及治疗后极危重患儿血清GAS、MTL水平高于非危重、危重患儿(P<0.05);治疗后非危重、危重、极危重患儿血清GAS、MTL水平与其治疗前比较,差异均有统计学意义(P<0.05)。不同疾病类型患儿血清GAS、MTL水平比较,差异无统计学意义(P>0.05)。胃肠功能障碍、胃肠功能衰竭患儿血清GAS水平高于无胃肠功能障碍患儿(P<0.05),胃肠功能衰竭患儿血清GAS水平高于胃肠功能障碍患儿(P<0.05);胃肠功能障碍患儿血清MTL水平高于无胃肠功能障碍、胃肠功能衰竭患儿(P<0.05),无胃肠功能障碍患儿血清MTL水平高于胃肠功能衰竭患儿(P<0.05)。结论不同病情严重程度、胃肠功能状态的患儿血清GAS、MTL变化是不同的,临床可通过监测患儿血清GAS、MTL变化来评估患儿病情严重程度、胃肠功能状态及临床治疗的效果。

Background Serum gastrin(GAS) and motilin(MTL) play important roles in regulating gastrointestinal motor function.Gastrointestinal dysfunction or gastrointestinal failure in critical illness is considered to be the inducement of multiple organ failure(MOF) after stress,so it is of great significance to monitor the levels of GAS and MTL.Objective To analyze the concentration changes of GAS and MTL in the blood of different children in pediatric intensive care unit(PICU) and their clinical monitoring significance.Methods Three hundred hospitalized children in Pediatric Intensive Care Unit of Pingxiang Maternal and Child Care Hospital from January 2018 to September 2019 were enrolled.The levels of GAS and MTL in the blood of children were measured by radioimmunoassay.The levels of GAS and MTL in blood of children with different disease severity(before and after treatment),different disease types and different gastrointestinal function states were compared.Results The levels of GAS and MTL of extremely critically ill children before and after treatment were higher than those of non-critically ill and critically ill children (P<0.05);after treatment,the GAS and MTL levels of non-critical,critically ill,and extremely critically ill children were compared with those before treatment,and the differences were statistically significant (P<0.05).There was no significant difference in the levels of GAS and MTL in children with different disease types(P>0.05).The level of GAS in children with gastrointestinal dysfunction and gastrointestinal failure was higher than that of children without gastrointestinal dysfunction,and the level of GAS in children with gastrointestinal failure was higher than that of children with gastrointestinal dysfunction (P<0.05).The MTL level of children with gastrointestinal dysfunction was higher than that of children without gastrointestinal dysfunction and gastrointestinal failure,and the MTL level of children without gastrointestinal dysfunction was higher than that of children with gastrointestinal failure (P<0.05).Conclusion In children with different disease severity and gastrointestinal function status,the changes of GAS and MTL are different.In the clinic,it is possible to monitor the changes in the concentration of GAS and MTL in the blood of the children to assess the severity of the disease,the gastrointestinal function status and the effect of clinical treatment in the children.