早产儿血胃动素和胃泌素的相关性研究

目的：探讨早产儿及合并缺氧缺血性脑损伤（hypoxic-ischemic brain damage, HIBD）早产儿胃肠激素水平；小剂量红霉素对喂养不耐受早产儿干预治疗的效果及其临床意义。方法：以50例早产儿为观察组，其中包括合并HIBD的早产儿23例，此为合并HIBD早产儿组；排除HIBD的早产儿27例，为排除HIBD早产儿组，其中存在喂养不耐受者18例为喂养不耐受早产儿组；9例喂养耐受的早产儿为喂养耐受早产儿组。以20例正常足月新生儿为正常对照组。应用放射免疫分析法（radioimmmunoassay，RIA）测定观察组和对照组喂养前血浆胃动素(motilin，MTL)和血清胃泌素(gastrin，GAS)的含量。对18例喂养不耐受早产儿中的12例予以小剂量红霉素3～5mg/(kg·d)进行干预治疗。结果：①HIBD合并早产者血中GAS和MTL水平均高于正常足月儿和排除HIBD的早产儿（P＜0.01）；②排除HIBD的早产儿血中GAS和MTL水平均低于正常足月儿(P＜0.05)；其中喂养不耐受的早产儿血中GAS和MTL水平与喂养耐受早产儿比较，差异均有统计学意义(P＜0.05），喂养耐受的早产儿血中GAS和MTL水平与正常对照组比较，差异均无统计学意义(P＞0.05)；③对喂养不耐受早产儿的红霉素干预治疗组与其对照组比较，患儿的喂养情况有明显改善(P＜0.05)。结论：早产儿存在MTL和GAS分泌异常，血中MTL和GAS水平与喂养不耐受有关，红霉素对喂养不耐受的早产儿有较好的治疗效果。

Correlations between the blood motilin and gastrin levels in premature infants

Objective: To explore the clinical significance of gastrointestinal hormone secretion in premature infants and premature infants with hypoxic-ischemic brain damage(HIBD), and to observe the therapeutic effect of erythromycin in small doses on premature infants with a feeding intolerance. Methods: Fifty premature infants including 23 with HIBD and 27 without HIBD (18 of the 27 with a feeding intolerance) were enrolled in this study. Twenty normal newborns were the control. The plasma motilin and serum gastrin levels were determined by radioimmmunoassay (RIA). The 12 infants with a feeding intolerance were subjected to 3-5mg/(kg·d)erythromycin. Results: ① Compared with the control and the premature infants without HIBD group, the blood MTL and GAS levels of premature infants with HIBD were higher(P＜0.01 ) . ②The blood MTL and GAS levels of premature infants without HIBD were lower than those of the control group(P＜0.05). There was a significant difference between the premature infants with a feeding intolerance and the premature infants without a feeding tolerance (P＜0.05), while there were not significant differences between the premature infants without feeding intolerance and the control group (P＞0.05). ③The effect of erythromycin was significantly different between the interventional group and the control group (P＜0.05). Conclusions: Premature infants have abnormal secretions of plasma motilin and serum gastrin. The blood level of MTL and GAS has a relationship to feeding intolerance and erythromycin therapy has a good effect on premature infants with feeding intolerance.