窒息后新生儿血中胃泌素和胃动素水平变化及相关因素探讨

目的探讨新生儿窒息后血中胃泌素、胃动素的变化及临床意义,以及促使其恢复的可能相关因素。方法将100例窒息新生儿分为轻度窒息组及重度窒息组,其中重度窒息组随机分为禁食组(A)与微量喂养联合非营养性吸吮组(B),用放射免疫法对出生后第1日喂奶前及第5日空腹血中胃泌素、胃动素浓度进行了测定,与正常新生儿作对照。结果①轻度窒息组生后第1日血中胃泌素、胃动素与对照组比较无显著性意义(P>0.05)。②重度窒息组生后第1日血中胃泌素、胃动素水平则明显低于对照组,有显著性意义(P<0.01);生后第5日空腹血中胃泌素、胃动素浓度均较生后第1日喂奶前升高(P<0.05);其中A组仍低于同期对照组水平(P<0.05),B组其水平较A组明显升高(P<0.01),与同期对照组无显著性差异(P>0.05)。结论①轻度窒息新生儿生后第1日新生儿血中胃泌素、胃动素的水平基本同正常新生儿,提示可酌情给予早期胃肠营养。②重度窒息新生儿生后第1日血中胃泌素、胃动素的水平明显降低,微量喂养联合非营养性吸吮可缩短两种激素水平恢复时间。

THE DYNAMIC CHANGES AND CORRELATION FACTORS OF BLOOD GASTRIN AND MOTILIN LEVELS IN ASPHYXIA NEWBORN

Objective To investigate the changes of serum gastrin and motilin levels and explore their value, and to inquire their possible recover factors related. Methods 100 asphyxia newborns were divided into 2 groups: low-grade asphyxia group and severe asphyxia group, and the severe asphyxia group was divided into group A(non- feeding) and groups B(early minimal feeding, EMF, and non-nutrition sucking, NNS). We measured serum gastrin and plasma motilin concentration via radioimmunoassay with them on the first day and the fifth day after birth before feeding, and compared with those of normal controls. Results ①The differences of gastrin and motilin in blood between low-grade asphyxia group and contrast group on the first day had not significant respectively (P>0.05). ②There was significant difference of gastrin and motilin in blood between severe asphyxia group and contrast group on the first day comparing with those of the fifth day (P<0.01). The concentrations of both hormones were enhanced on the fifth day (P<0.01). Among them the group A still lower than that of the normal controls level on the same period (P<0.05), and compare with group B, its level went up obviously (P<0.01), which had not significant difference respectively with those of the normal controls levels on the same period (P>0.05). Conclusion ① The level of gastrin and motilin in blood in low- grade asphyxia and normal new born was alike, which suggested that forepart feed could be taken into consideration. ② The level of gastrin and motilin in blood in severe asphyxia group reduce obviously, and EMF and NNS could shorten the instauration time of two kinds of hormones level.