
慢性胃炎患儿血中胃泌素胃动素生长抑素变化的研究
Levels of blood gastrin, motilin and somatostatin in children with chronic gastritis
目的:胃肠激素是维持胃肠动力功能的重要调节因素,胃肠动力病学研究在国外已开展数十年,而国内小儿胃肠动力病仅在最近几年受到关注,有关基础与临床研究有相当重要的意义。该研究旨在探讨小儿慢性胃炎血中胃泌素(GAS)、胃动素(MTL)、生长抑素(SS)分泌变化与疾病的关系。 方法:采用放射免疫法对50例观察组慢性胃炎患儿(含Hp阳性组21例、Hp阴性组29例)及30例对照组患儿的空腹血GAS,MTL,SS进行测定。并对50例观察组患儿行胃镜检查,取胃窦粘膜2块及十二指肠球部粘膜1块作快速尿素酶试验(RUT)和病理组织学Giemas染色。 结果:①慢性胃炎组患儿血清GAS含量均值为 141.5±28.0 ng/L,高于对照组均值68.7±17.9 ng/L,差异有显著性(t=4.317,P<0.01)。同时Hp阳性组GAS含量均值为173.0±46.0 ng/L,亦明显高于Hp阴性组均值110.0±20.0 ng/L,差异有显著性(t=3.274,P<0.01)。②慢性胃炎组患儿血浆MTL含量均值为 199.5±61.0 ng/L,低于对照组均值 281.0±76.0 ng/L,差异有显著性(t=4.416,P<0.01)。Hp阳性组血浆MTL含量与阴性组之间差异无显著性。③慢性胃炎组患儿血清SS含量均值为 166.4±18.0 ng/L,低于对照组均值 229.0±45.0 ng/L,差异有显著性(t=2.131,P<0.05)。Hp阳性组血清SS含量均值为144.5±11.0 ng/L,明显低于Hp阴性组均值187.4±26.0 ng/L,差异有显著性(t=3.897,P<0.01)。 结论:慢性胃炎患儿存在胃肠激素的异常分泌, 其分泌水平的异常在慢性胃炎的发病机制中起重要作用,并为慢性胃炎患儿是否存在Hp感染,提供了诊断和治疗的理论依据。[中国当代儿科杂志,2004, 6(4): 287-290]
OBJECTIVE: To measure the levels of blood gastrin (GAS), motilin (MTL) and somatostation (SS) in children with chronic gastritis and to explore the relationship between blood GAS, MTL and SS levels and the pathogenesis of chronic gastritis in children. METHODS: Fasting blood GAS, MTL and SS levels were measured by radioimmunoassay in 50 children with chronic gastritis [Gastritis group, 21 Helicobacter pylori (Hp) positive, 29 Hp negative] and compared to those in 30 age-matched normal children (Control group). Gastroscopy was performed for the children in the Gastritis group and then mucosal speciments obtained from antrum of stomach and duodenal ampulla were sent for RUT and histopathologic Giemas staining. RESULTS: (1) The serum GAS level in the Gastritis group ( 141.5± 28.0 ng/L) was significantly higher than that in the Control group ( 68.7± 17.9 ng/L) (P< 0.01). In the Gastritis group, the serum GAS level in children who were Hp-positive ( 173.0± 46.0 ng/L) was significantly higher than that in those who were Hp-negative ( 110.0± 20.0 ng/L) (P< 0.01). (2) The serum MTL level in the Gastritis group was significantly lower than that in the Control group ( 199.5± 61.0 ng/L vs 281.0± 76.0 ng/L) (P< 0.01). There was no statistically significant difference in MTT between the Hp-positive and Hp-negative children. (3) The serum SS level in the Gastritis group was also lower than that in the Control group ( 166.4± 18.0 ng/L vs 229.0± 45.0 ng/L) (P< 0.05). In the Gastritis group, the serum SS level in Hp-positive children was significantly lower than those who were Hp-negative ( 144.5± 11.0 ng/L vs 187.4± 26.0 ng/L) (P< 0.01). CONCLUSIONS: Blood GAS, MTL and SS levels are different in children with chronic gastritis, which might be part of the pathogenesis of chronic gastritis. Determinations of blood GAS and SS levels may be useful in the diagnosis of Hp infection in chronic gastritis.
Chronic Gastritis / Gastrins / Motilin / Somatostatin / Child