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目的探讨厌食症患儿血浆瘦素、神经肽Y、胃动素与胃排空的关系。方法2007年9月至2008年8月在广州医学院荔湾医院门诊就诊符合厌食症诊断标准的患儿40例作为厌食组,采用放免法检测血浆神经肽Y(Neuropeptide Y,NPY)、胃动素(Motilin)及用ELISA法检测血浆瘦素(Leptin,LP),并进行B超胃液体排空功能试验。同时以30名健康儿童作为对照组行相应检查。结果厌食组血浆LP水平低于对照组,NPY、胃动素水平也较对照组明显降低,差异有统计学意义(P<0.01)。厌食组胃液体排空功能试验示,餐后60、90和120min时胃窦残留率均明显高于对照组,差异有统计学意义(P<0.01),餐后30min胃窦残留率与对照组比较,差异无统计学意义。结论厌食症患儿血浆抑制食欲因子LP降低不是导致厌食的主要原因;血浆食欲促进因子NPY降低导致胃动素不足,胃排空障碍,胃潴留增加;厌食症患儿血浆LP与NPY之间的反馈调节机制可能存在障碍。
Objective To investigate the relationship between plasma leptin, neuropeptide Y, motilin and gastric emptying in children with anorexia. Methods From September 2007 to August 2008, 40 children with anorexia syndrome diagnosed in Liwan Hospital of Guangzhou Medical College were enrolled as anorexia group. The levels of neuropeptide Y (NPY), motilin (Motilin), and the plasma leptin (Leptin, LP) by ELISA, and the B-gastric emptying function test. At the same time to 30 healthy children as the control group to check accordingly. Results The level of plasma LP in the anorexia group was lower than that in the control group. The levels of NPY and motilin in the anorexia group were also significantly lower than those in the control group (P <0.01). Anorexia group gastric emptying function tests showed that after 60, 90 and 120min postprandial gastric residual rate were significantly higher than the control group, the difference was statistically significant (P <0.01), 30min postprandial gastric residual rate and the control group Comparison, the difference was not statistically significant. Conclusion The decrease of plasma LPA was not the main cause of anorexia in children with anorexia. The decrease of plasma appetite promoting factor NPY resulted in the lack of motilin, gastric emptying and gastric retention. In children with anorexia, the plasma LP and NPY Feedback regulation mechanism may be obstacles.