胃肠激素与食管运动

胃肠激素通过多种方式影响和调节食道运动，有的促进食管运动，增加下食管括约肌压力；有的抑制食管运动，降低下食管括约肌压力。本文就此方面作一综述。1 促进食管运动的胃肠激素1.1 胃动素 1966年Brown等发现的胃动素(motilin)是22肽的脑肠肽，由分布于胃肠道及神经系统的Mo     

小儿腹泻病血胃泌素、胃动素和生长抑素含量变化与胃肠运动功能的关系

目的：探讨小儿迁延性及慢性腹泻病血中胃泌素（GAS），胃动素（MOT）和生长抑素（SS）的变化情况和它们与胃肠动力紊乱的关系。方法：应用放免法对28例迁延性及慢性腹泻病患儿治疗前和恢复期晨空腹及餐后1小时的血GAS，MOT和SS水平进行测定，并用实时超声显像法对他们餐后的胃运动及胃排空进行研究，同时与22例正常儿童作比较。结果：患儿治疗前空乃和餐后的血清GAS和血浆MOT水平高于恢复期和对照组（P＜0．001），空腹的血浆SS水平尽管前者亦高于后两者（P＜0．05），但餐后差异无显著性（P＞0．05），患儿治疗前空腹和餐后的GAS／SS和MOT／SS比值明显大于恢复期和正常儿童（P＜0．05），患儿病期的胃体蠕动频率（FB），胃窦收缩频率（FA）和30，60，90，及120分钟胃排空率（GER）明显增快，而且120分钟GER与空腹和餐后的血浆SSI 各组都呈负相关，与GAS／SS和MOT／SS的比值则呈正相关。结论：迁延性及慢性腹泻小儿血中的GAS和MOT水平升高，GAS／SS和MOT／SS比值增大，而且GAS，MOT和SS分泌失调与胃肠动力异常有密切的关系。     

小儿胃食管反流病与食管功能及胃肠激素的关系

目的了解儿童GERD患者血浆胃泌素、胃动素浓度变化与下食管括约肌(LES)功能不全之间的相关性,以探讨儿童GERD的发病机理.方法对30例有明显胃食管反流症状并经24小时食管动态pH监测确诊有病理性胃酸反流的患儿(观察Ⅰ组)进行食管腔内压力测定,了解其下食管括约肌长度(LESL)、下食管括约肌压力(LESP)、短暂性下食管括约肌松驰(TLESR)及屏障压(BP),同时测定血浆胃泌素、胃动素浓度.并设观察Ⅱ组及正常对照组进行比较.结果观察Ⅰ组LESP、BP与观察Ⅱ组相比差异有显著意义.观察Ⅰ组病人的TLESR现象较观察Ⅱ组明显增多.血浆胃泌素浓度观察Ⅰ组较观察Ⅱ组及对照组有所下降,但经统计学处理差异无显著性.血浆胃动素浓度观察Ⅰ组较观察Ⅱ组及对照组浓度有所升高,但经统计学处理差异无显著性.结论LESP和BP降低及TLESR在GER发病中起重要的作用.儿童GERD患者血浆胃泌素水平变化不大,酸反流的发生并不是由于胃酸分泌增加而是抗反流的防御机制下降所致.     

小儿营养不良的防治

营养不良是一种慢性营养缺乏症,多发生于热量和(或)蛋白质摄入不足的3岁以下婴幼儿,主要表现为渐进性消瘦,皮下脂肪减少,水肿等,常伴有各器官不同程度的功能紊乱,严重时可导致新陈代谢失常,威胁患儿生命。喂养不当是引起营养不良的主要原因,疾病影响导致长期摄入食物不能充分消化吸收,以及代谢消耗过多,皆可造成营养不良的发生。营养不良可分为消瘦性和浮肿性两种,消瘦性营养不良是总热量、蛋白     

浦城县小儿营养不良情况分析

营养不良是影响小儿生长发育不可疏忽的重要因素,而营养不良又受多种因素的影响,为了解我县儿童的营养状况,为我县儿童保健提供科学依据,我所于1999年4～6月对全县幼儿园的儿童进行了全面的体格检查及调查。1 对象与方法1.1 对象 全县24所幼儿园共2189名儿童,其中最小的儿童是2周3个月,最大的儿童是6周10个月。1.2 方法 按福建省0～7岁儿童保健手册标准测量身高,体重,采用1983年世界卫生组织推荐0～7岁正常男、女童年龄别     

魔芋多糖对小鼠胃肠组织胃动素与生长抑素的影响

目的探讨魔芋多糖(Konjac polysaccharide,KP)对小鼠胃肠组织的胃动素与生长抑素的影响。方法将实验动物随机分为正常对照(NC)和KP高、中、低剂量(KPH、KPM、KPL)4组,前者给予普通饲料,后三者每100g普通饲料中分别加入KP0.8、0.4和0.2g,连续喂饲20d。应用放射免疫法测定小鼠胃肠组织胃动素生长抑素水平,血糖仪测定血糖并称重体重、体脂和粪便湿重等指标。结果KPH组胃动素为8.26±0.53ng/g,较NC组升高;生长抑素为207.32±21.89ng/g,较NC组降低。各项指标的差别均有显著性意义(P<0.05)。结论KP可提高小鼠胃肠组织的胃动素水平,降低其生长抑素水平。     

喂养困难小儿餐前后的血胃泌素与生长抑素水平

儿科临床中见可遇到一些长期喂养困难的小儿，没有任何医学上的原因可以解释其食欲不良。近来已发现消化道功能与消化道同份泌水平有关，本文研究了１２例厌食小儿的血胃泌素与生长抑素水平。１２例９月－４．５岁小儿的体重和身高明显低于同龄同性别小儿，但无任何明显的疾病存在。取晨空腹周围血测基础胃泌素与生长抑素水平，进食后１ｈ再测其变化。血胃泌素与生长抑素采用放免法测定。结果 示厌食小儿基础生长抑素水平２倍于对照     

营养不良小儿膳食分析

本文总结了１９９２年５～６月对责任街道幼托机构体检筛查出的８４例２～６岁营养不良小儿膳食分析资料。表明经济条件好转，但因喂养不合理以致热能与蛋白质摄入量不足者各占总数的４０．４８％和３２．１４％。对于后者，因优质蛋白和必需氨基酸所占比例较高，蛋白质吸收率好，因此血浆蛋白测定５９例中无一例白蛋白及总蛋白降低。但因热能不足，蛋白质被充当产热物质，导致体重增长停顿乃至降低，故应调整饮食，以增加热能为主，蛋白质补充次之。另外也应注意钙、锌及维生素Ｂ１及Ｃ的补充。     

小儿营养不良的防治对策

营养不良是严重危害儿童身心健康的常见疾病。建国以来，营养不良防治工作一直得到我国政府的高度重视和广大儿童保健工作者的努力．其患病率明显下降，至2000年底，基本实现了《九十年代中国儿童发展规划纲要》中5岁以下儿童中重度营养不良患病率降低的目标。然而，近年资料报道显示，5岁以下儿童营养不良(低体重)患病率较贫困农村和农村分别高达20．8％和10．09％，居民经济水平较低，城区患病率达8．38％。可见，边远、经济不发达地区儿童营养不良仍是一个十分严重的问题，抓好小儿营养不良防治仍是新时期儿童保健工作的重点之一，它对实现儿童新《纲要》的目标具有深远的意义。为此，本文对小儿营养不良的防治对策作一综述。     

母乳胃动素和胃泌素浓度测定及其意义

本文测定了45例正常产妇的血及初乳中胃动素和胃泌素浓度,结果发现,母乳胃动素(206.53±110.42ngL)和胃泌素浓度(150.42±58.00ng/L)均达到母血胃动素(443.05±40.79ng/L)和胃泌素浓度(301.32±100.98ng/L)的二分之一水平。提示母乳可为新生儿提供一定数量的胃动素和胃泌素。本文对乳汁中胃动素和胃泌素进入新生儿体内的作用进行了初步讨论。     

Abnormal dark adaptation in adult patients with protein-energy malnutrition: Correction by protein-energy repletion

Markedly abnormal dark adaptation was observed in three patients with treated pancreatic insufficiency and one patient with histologically inactive alcoholic cirrhosis despite normal serum vitamin A (>40 μg/dl) and zinc levels (>70 μg/dl). Intrinsic retinal disease was excluded by extensive ophthalmological examinations in each case. Abnormal dark adaptation was associated with protein-energy malnutrition in all patients. In two patients, dietary protein repletion without supplemental vitamin A or zinc led to a rise in serum albumin and serum vitamin A transport proteins, and correction of the dark adaptation abnormality. No change was observed in total serum vitamin A and serum zinc levels after protein repletion for six weeks. These observations may indicate impaired peripheral utilization of retinol in chronically ill patients with protein-energy malnutrition.     

Effect of erythropoietin and testosterone on bone marrow RNA synthesis in rats with protein-energy or protein malnutrition

RNA synthesis was studied in bone marrow of rats with protein-energy malnutrition (PEM) and protein malnutrition (PM) after the administration of erythro-poietin (Epo) and/or testosterone (Te). RNA synthesis appeared slighty increased in PEM animals, 25% by Epo; 66% by Te while not alteration was induced by Epo and Te together. In PM rats a considerable decrease of RNA synthesis was observed. These results would indicate that the use of ¹⁴C-formate as a labelled precursor to estimate DE NOVO RNA synthesis is a reliable experimental variable for testing bone marrow function. The data presented suggest that while in PEM the biochemical machinery required to synthesize RNA remains basically unchanged. PM induces important metabolic disturbance.     

蛋白质-能量营养不良与脑功能的关系

脑的正常发育和功能的实现需要氨基酸、维生素、微量元素和必需脂肪酸等营养成分的持续供应,而这些营养成分除参与体内能量代谢外,还参与蛋白质、酶和神经递质等的合成,直接或间接地影响脑的功能。以下就蛋白质-能量营养不良与脑功能关系的研究进展作一综述。     

Absence of protein-energy malnutrition in Prague homeless

Summary Objective: Define the prevalence of protein-energy malnutrition (PEM) in a convenient sample of Prague’s homeless population. Methods: The study was conducted in Prague over an 8 month period during 2003. Nutritional status was assessed using anthropometric measurements, biochemical and hematological indicators. Of the initial 217 subjects recruited, 201 participated actively. Thirteen percent of the participants were women. One hundred and thirty four participants were interviewed on the premises of Naděje, a Czech charitable organization; the rest were interviewed in Bulovka University Hospital. Results: Mean BMI values were within the normal range, with only 6 (3%) of the men and 2 (7%) of the women below 18.5 kg/m². Wasted muscle mass was found in only 1 (0.6%) man. Serum protein levels were within normal limits. Lymphocytopenia was reported in 3 (2%) of the men. Results of the CAGE questionnaire gave a strong indication of alcoholism in 24 (12%) and alcoholism in 32 (16%) of the participants. Conclusions: The data fails to demonstrate the existence of protein-energy malnutrition in Prague’s homeless population. Submitted: 9 February 2006; Revised: 23 May, 31 October 2006, 4 January 2007; Accepted 26 April 2007     

Detection of moderate protein-energy malnutrition in pre-school children

Several biochemical and anthropometric tests were used to define the states of mild or moderate protein-energy malnutrition among 810 children aged under five years in the forest region of Southern Cameroon. The results show that the percentage and the identity of children classified as undernourished may be different according to the anthropometric test employed. The mean values of most of the biochemical variables assayed decrease in the groups affected with moderate weight and arm deficiencies. A system is proposed for the evaluation of the nutritional status based on the simultaneous use of four anthropometric tests. Some biochemical parameters may be useful for establishing a diagnosis.     

深圳市5岁以下儿童营养不良现状研究

[目的]掌握本地区5岁以下儿童营养不良现状,了解影响儿章营养问题的主要因素. [方法]采用横断面调查方法,整群随机抽取本辖区5个社区与12所托幼机构,12 928例5岁以下儿童,进行体格发育评估与问卷调查,影响因素分析应用二分类反应变量的Logistic逐步回归方法. [结果] 5岁以下儿童营养不良患病率为3.77%,性别差异无统计学意义(P＞0.05);6个月内婴儿营养不良患病率低,6个月以后开始增高,小于6个月组与其他年龄组间两两比较差异均有统计学意义(P＜0.05),6个月以上组组间差异无统计学意义(P＞0.05);Logistic逐步回归分析提示,托幼机构膳食合理、保证每天10 h以上睡眠、辅食添加合理、定期营养监测、1岁后保证每天有2次奶、4个月内母乳喂养共6个因素能促进儿童营养状况改善,而偏食挑食、喜欢膨化食品、早产、进食速度慢、爱喝甜饮料、出生低体重、经常吃零食则是导致儿童营养不良的因素. [结论]预防儿童营养不良必须采取综合措施,加大科学喂养宣传力度,提倡合理的膳食结构,培养良好的饮食习惯.     

151例儿童营养不良的病例对照研究

[目的]探讨儿童营养不良的危险因素,为预防儿童营养不良的发生提供科学依据.[方法]按1:2配对原则,以统一的调查表和调查方式对151例病例组患儿和302例对照组儿童进行调查.应用SPSS 10.0软件对调查因素进行单因素和多因素Logistic回归分析.[结果]单因素分析表明母亲文化程度、家庭经济收入低、家庭不和睦、父母离异、母亲不知道合理营养、常吃水果、蔬菜、常吃豆制品和肉蛋奶类食品、偏食、常吃零食、食量小、近2个月内患严重疾病、经常患病等1 4项因素与营养不良发生有关.多因素条件Logistic回归分析发现家庭收入低(OR=3.0419)、家庭不和睦(OR=2.6347)、母亲不知道合理营养(OR=3.2851)、偏食(OR=4.5821)、经常患病(OR=2.1632)是儿童营养不良的危险因素;而母亲文化程度高(OR=0.5162)、经常吃蔬菜(OR=0.4794)、常吃肉蛋奶类(OR=0.2319)是保护因素.[结论]儿童营养不良是多因素综合作用的结果,应采取综合干预措施来控制儿童营养不良的发生.     

Prenatal protein-energy malnutrition and its recovery of mandible and long bone in newborn rats

Pregnant rats were fed either a 25% protein diet as controls or a 10% protein diet from day 13 of gestation to birth. Immediately after birth (day 1), calcium uptake and collagen synthesis were studied in the mandible and long bone of the new-borns. Control dams were fed continuously a 25% protein diet and prenatally malnourished dams were fed either a 25% protein diet or continuously a 10% protein diet untill day 15. The mandibles and long bones were then studied to determine the recovery of the prenatal malnutrition at day 15. At the time of birth, body weight and the weights of the mandibles and long bones were affected to approximately the same extent. Calcium and collagen contents of the mandible in the malnourished groups were less when compared to the controls, but no differences were observed in the long bone between groups. On the other hand, calcium uptake and collagen synthesis in the mandibles were greater in the malnourished group than that of the controls, but no differences in the long bones were observed. At day 15, body weight and the weights of the mandibles and long bones in the rehabilitated group were about the same as that of the controls. Furthermore, there was no difference in calcium and collagen contents as well as collagen systhesis between these groups, but calcium uptake in the rehabilitated group was greater. The differences in body weights and the weights of the mandibles and long bones of the continuously malnourished group compared to the controls were increased by day 15. The calcium and collagen contents of this group were less, also. However, calcium uptake and collagen synthesis in the mandibles and long bones in the continuously malnourished group were increased compared to the control group. It is concluded that both mandibles and long bones can be successfully rehabilitated, if refeedings are initiated properly and early.