不同胎龄不同喂养方式早产儿胃肠激素浓度变化的研究

目的:观察不同胎龄早产儿胃动素(MOT)与胃泌素(GAS)浓度变化及其不同喂养方式对MOT及GAS的影响。方法:80例早产儿按不同喂养方式分为自吸吮组、胃管饲养组、胃管饲养加静脉营养组3组,应用放射免疫法检测其生后12h内开奶前及第7天空腹MOT与GAS的浓度,并以20例足月新生儿作为对照。结果:(1)所有新生儿生后12h的血中MOT、GAS浓度均明显低于生后第7天(P<0.01);早产儿组生后12h内及第7天空腹血中MOT、GAS浓度均明显低于对照组(P<0.05),随胎龄增加其血中MOT、GAS浓度亦升高(P<0.05~0.01);(2)生后第7天自吸吮组早产儿血中MOT、GAS浓度明显高于胃管饲养组、胃管饲养加静脉营养组,差异有统计学意义(P<0.05)。结论:胃肠内分泌细胞功能随胎龄增加逐渐发育成熟,MOT及GAS对未成熟儿胃肠结构和功能完善有促进作用,自吸吮奶汁较胃管饲养有利于胃肠道激素浓度的提高。

The changes of blood gut hormone concentration in preterm infants and the relationship with feeding patterns and gestation age

Objective:To study the changes of serum motilin and gastrin concentrations and the relationships with feeding patterns in preterm infants. Methods: The serum motilin and gastrin concentrations in 80 preterm infants(divided into 3 groups by feeding patterns: self-sucking infants, tube-feeding infants, tube-feeding and parenteral nutritional infants)were measured within 12 hour before enteral feeding, on the 7th day of life by using radioimmunoassay, 20 term infants were studied as controls. Results: (1) The serum concentration of motilin and gastrin within 12 hour before enteral feeding were significantly lower than those on 7th day of life in all infants (P<0.01); the serum concentration of motilin and gastrin in preterm infants within12 hour before enteral feeding, on the 7th day of life were significantly lower than those in control group respectively (P<0.05). (2) Concentration of motilin and gastrin in self-sucking preterm infants were higher than other two preterm groups. Conclusions: The functions of gastrointestinal endocrine cells are developing gradually with gestation age. The motilin and gastrin can promote the gastroinstinal growth and development. Self-sucking milk can help the promotion of more gastroinstinal hormone than tube-feeding method.