摘要
目的 观察红霉素对喂养困难儿 (喂养困难组 )胃肠动力的影响。方法 收集 1997年11月～ 1999年 2月的 2 7例喂养困难的新生儿作为观察对象 ,77例正常新生儿作为对照组。用 3～ 5mg (kg·d)的小剂量红霉素进行干预。采用99mTc DTPA放射性核素胃食管显像和放免法测定血清胃泌素、血浆胃动素 ,以反映胃肠动力状况。采用自身前后对照比较红霉素的疗效。结果 喂养困难组的6 0min胃排空率为 (2 3± 13) % ,低于对照组的 (4 1± 15 ) % (P <0 .0 0 1) ;反流指数 (17± 9)明显高于对照组 (5± 3) (P <0 .0 0 1)。喂养困难组血清胃泌素水平为 (5 3± 13)ng L ,较对照组的 (6 6± 2 2 )ng L为低 (P <0 .0 0 1) ;血浆胃动素水平为 (5 83± 2 5 3)ng L ,也较对照组的 (711± 2 10 )ng L为低 (P <0 .0 5 )。用小剂量红霉素干预 (7.8± 2 .2 )d后 ,喂养困难组的喂养情况改善 ,用药前胃排空率为 (2 3± 13) % ,用药后升至 (39± 17) % (P <0 .0 0 1) ;反流指数从 17± 9降至 8± 6 (P <0 .0 0 1) ;血浆胃动素水平明显升高 ,从 (5 83± 2 5 3)ng L升至 (90 8± 30 1)ng L(P <0 .0 0 1) ;而血清胃泌素水平变化不明显 ,从 (5 3± 13)ng L到 (5 9± 2 0 )ng L (P >0 .0 5 )。结论 喂养困难组患儿存在胃肠道动力障碍 ,小?
Objective To compare the gastrointestinal motility between normal neonates and neonates who had feeding difficulties and to investigate whether erythromycin can promote neonatal gastrointestinal motility. Methods 99m Tc DTPA gastroesophageal scintigraphy and radioimmunoassay were used to measure the gastrointestinal motility. The parameters were GE 60 %, reflux index (RI) and the level of serum gastrin, plasma motilin. Seventy seven normal neonates and 27 neonates suffering from feeding problems were enrolled in this study during the period from November, 1997 till February, 1999. Results Feeding intolerant neonates had lower GE 60 % (23±13)% vs (41±15)% ( P <0.001) , more gastroesophageal RI (17±9) vs (5±3) ( P <0.001) lower concentration of serum gastrin (53±13) ng/L vs (66±22) ng/L ( P <0.001) and plasam motilin (583±253) ng/L vs (711±210) ng/L ( P <0.05) as compared with normal neonates. After intravenous infusion with erythromycin at 3～5 mg/(kg·d) for (7.8±2.2) days, GE 60 % and RI were improved significantly in neonates with feeding difficulties. GE 60 % was (23±13)% before using erythromycin, and increased to (39±17)% after the treatment ( P <0.001); while RI decreased from (17±9) to (8±6) ( P <0.001). Before infusing erythromycin, plasma level of motilin was (583±253) ng/L, after infusion it increased to (908±301) ng/L ( P <0.001). But serum level of gastrin didn't change significantly (53±13) ng/L vs (59±20) ng/L ( P >0.05). Conclusion Feeding intolerant neonates had abnormal gastrointestinal motility. Small dose of intravenous erythromycin promoted neonatal gastrointestinal motility.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2000年第11期696-698,共3页
Chinese Journal of Pediatrics
