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血浆胃动素水平与早产儿喂养不耐受的相关性研究
Relationship between plasma motilin level and feeding intolerance in preterm infants
目的：观察早产儿生后血浆胃动素（MOT）水平的变化，探讨其与早产儿喂养不耐受（FI）的相关性，阐明早产儿FI可能存在的影响因素。方法：112例早产儿中59例为喂养耐受（feeding tolerance, FT）组，53例为喂养不耐受（FI）组，应用放射免疫法检测生后第1、4、7、14日的血浆MOT水平；收集FI组早产儿的临床资料行logistic多因素回归分析。结果：（1）早产儿FI组生后第1、4、7、14日血浆MOT水平明显低于FT组（P<0.05），MOT水平随胎龄、日龄、肠内喂养量的增加而逐渐升高；（2）早产儿胎龄越小，FI持续时间越长；（3）FI组早产儿生后第1日MOT水平与FI持续时间之间存在负相关（r=-0.913，P<0.001）；（4）胎龄、产前使用糖皮质激素是FI的保护因素；宫内窘迫、胎盘异常和围生期感染是FI发生的危险因素。结论：血浆MOT水平变化可能与早产儿FI的发展过程密切相关，早期监测血浆MOT变化有助于尽早判断FI的发生。
OBJECTIVE: To observe changes in plasma motilin (MOT) level among preterm infants after birth, to investigate the relationship between plasma motilin level and feeding intolerance (FI), and to clarify the possible risk factors. METHODS: A total of 112 preterm infants were divided into feeding tolerance (FT) group (n=59) and FI group (n=53). Their plasma MOT levels were measured by radioimmunoassay on days 1, 4, 7 and 14 of life. The clinical data of FI group were collected and subjected to multivariate logistic regression analysis. RESULTS: Compared with the FT group, the FI group showed significantly lower plasma MOT levels on days 1, 4, 7 and 14 of life (P<0.05), and there was a positive correlation between plasma MOT level and gestational age, age in days, and volume of enteral feeding in the FI group. The lower the gestational age, the longer the FI duration. There was a negative correlation between the plasma MOT level on day 1 of life and the FI duration (r=-0.913, P<0.001). Gestational age and prenatal use of glucocorticoid were protective factors for FI, while fetal distress, placental abnormality and perinatal infection were risk factors for FI. CONCLUSIONS: Change in plasma MOT level may be closely related to the development of FI in preterm infants. Early monitoring of plasma MOT level may be useful for predicting the occurrence of FI.
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