目的　探讨重型颅脑损伤患者血清胃泌素变化及其与消化道出血的关系。方法　对 6 5例重型颅脑损伤患者 ,根据伤后是否合并消化道出血分为出血组及无出血组 ,用放射免疫法分别于入院时及第3、7、14天测定血清胃泌素含量并与正常对照组进行比较。结果　重型颅脑损伤早期血清胃泌素含量均明显高于正常对照组 (P <0 .0 1) ;3～ 7d达高峰 ,伤后 1周内有、无出血组间差异明显 (P <0 .0 1) ;随着病情好转 ,血清胃泌素值逐渐下降 ,伤后 2周 ,出血组血清胃泌素水平明显高于无出血组 (P <0 .0 1)。结论　血清胃泌素浓度与脑损伤程度及消化道出血呈正相关 ,早期动态观察血清胃泌素含量变化对判断病情及预后有重要意义。 Objective To investigate the changes of serum gastrin in patients with severe craniocerebral injury and its relationship with gastrointestinal bleeding. Methods Sixty-five patients with severe traumatic brain injury were divided into hemorrhage group and non-hemorrhage group according to whether hemorrhage was caused by gastrointestinal hemorrhage or not. Radioimmunoassay was used to determine serum gastrin levels on admission and on days 3, 7 and 14 And compared with the normal control group. Results The levels of serum gastrin in the early stage of severe traumatic brain injury were significantly higher than those in the normal control group (P <0.01), and peaked at 3 to 7 days (P <0, P <0 .0 1). Serum gastrin levels gradually decreased with the improvement of the disease. Serum gastrin level in the bleeding group was significantly higher than that in the non-bleeding group (P <0.01) 2 weeks after injury. Conclusion Serum gastrin concentration is positively correlated with the degree of brain injury and gastrointestinal bleeding. The change of serum gastrin level in early dynamic observation is of great significance in judging the disease and prognosis.