摘要 目的：观察早产儿生后血浆内血管活性肠肽（VIP）水平的变化趋势，探讨其与早产儿喂养不耐受（FI）的相关性。方法：112例早产儿为研究对象，其中53例为FI组，59例为对照组，应用放射免疫法检测生后1、4、7、14 d的血浆VIP浓度。结果：（1）早产儿FI组生后1、4、7 d空腹血浆中VIP浓度分别为129±46、144±32及166±31 pg/mL，明显低于对照组的195±63、197±31及205±34 pg/mL（P＜0.05），但随胎龄、日龄、肠内喂养奶量的增加而逐渐升高。生后14 d FI 组的VIP浓度为198±41 pg/mL，对照组为202±48 pg/mL，两组比较差异无统计学意义；（2）早产儿胎龄越小，FI的持续时间越长；（3） FI组早产儿生后1 d VIP水平与FI的持续时间之间存在负相关（r=-0.799，P＜0.05）。结论：血浆VIP水平变化可能与早产儿FI的发生、发展密切相关，早期监测血浆VIP水平有助于及早判断发生FI的可能性。
Abstract：OBJECCTIVE: To study the changes of plasma vasoactive intestinal peptide (VIP) levels and the relationship of plasma VIP levels with feeding intolerance (FI) in preterm infants. METHODS: Plasma VIP concentrations were measured using radioimmunoassay in 53 preterm infants with FI 1, 4, 7 and 14 days after birth. Fifty-nine preterm infants without FI served as the control group. RESULTS: The fasting plasma concentrations of VIP in the FI group 1, 4 and 7 days after birth (129±46, 144±32 and 166±31 pg/mL respectively) were significantly lower than those in the control group (195±63, 197±31 and 205±34 pg/mL respectively) (P＜0.05). The increased plasma VIP concentrations were associated with the increased gestational age, age in days and enteral feeding volume in the FI group. By 14 days, the plasma concentrations of VIP in the FI group (198±41 pg/mL) were similar to those in the control group (202±48 pg/mL) (P>0.05). The younger the infant′s gestational age, the more prolonged the FI. Plasma levels of VIP on day 1 of life in the FI group were negatively correlated with the duration of FI (r=-0.799, P＜0.05). CONCLUSIONS: Plasma levels of VIP might be related to the development of FI in preterm infants and might serve as a predictor of FI.
XU Jing,HUANG Run-Zhong,HUANG Jian-Wei et al. Relationship between plasma levels of vasoactive intestinal peptide and feeding intolerance in preterm infants[J]. CJCP, 2011, 13(6): 451-454.
［3］Clark RH, Wagner CL, Merritt RJ, Bloom BT, Neu J, Young TE, et al. Nutrition in the neonatal intensive care unit: how do we reduce the incidence of extrauterine growth restriction?［J］. J Perinatol, 2003, 23(4):337-344.
［4］Sreedharan SP, Huang JX, Cheung MC, Goetzl EJ. Structure, expression and chromosomal localization of the type I human vasoactive intestinal peptide receptor gene［J］．Proc Natl Acad Sci USA,1995, 92(7): 2939-2943.
［5］Nylander O, Sjoblom M. Modulation of mucosal permeability by vasoactive intestinal peptide or lidocaine affects the adjustment of luminal hypotonicity in rat duodenum［J］. Acta Physiol (Oxf), 2007, 189(4): 325335.
［6］Ekblad E, Bauer AJ.Role of vasoactive intestinal peptide and inflammatory mediators in enteric neuronal plasticity［J］．Neurogastroenterol Motil, 2004, 16（Suppl 1）:123-128.
［7］van Haver ER, de Vooght L, Oste M, Sangild PT, Thymann T, Weyns AL, et al. Postnatal and diet-dependent increases in enteric glial cells and VIP-containing neurones in preterm pigs［J］. Neurogastroenterol Motil, 2008, 20(9):1070-1079.
