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目的对危重患儿多器官功能障碍(MODS)时血促胃液素(GAS)、胃动素(MTL)及胰岛素样生长因子-1(IGF-1)进行检测,探讨其水平变化与器官功能障碍或衰竭的关系。方法采用放射免疫法对危重患儿50例及非危重患儿30例血GAS、MTL及IGF-1进行检测,并与30例正常对照组进行比较。结果危重患儿血GAS、MTL及IGF-1各组均数差异有显著性(F=49.61,55.18,18.23 P均<0.001),胃肠功能障碍组血GAS、MTL及IGF-1水平变化与非胃肠功能障碍组比较差异有显著性(t=4.455、4.241、2.672 P均<0.001)。危重患儿器官功能障碍中4个器官功能障碍与2个器官功能障碍比较,MTL与IGF-1差异有显著性,GAS差异无显著性。危重患儿治疗前后血GAS、MTL及IGF-1水平及非危重组与正常对照组比较差异有显著性(t=3.232、4.352、4.706 P均<0.001)。结论危重患儿MODS时血GAS、MTL及IGF-1可能参与危重症病情的发展,且与胃肠功能障碍及MODS发生有关,结合患儿临床对其血GAS、MTL及IGF-1进行监测,对估计患儿病情严重程度及治疗有重要指导意义。
Objective To investigate the levels of plasma gastrin (GAS), motilin (MTL) and insulin-like growth factor-1 (IGF-1) in critically ill children with multiple organ dysfunction (MODS) Or failure of the relationship. Methods The levels of GAS, MTL and IGF-1 in 50 critically ill children and 30 non-critically ill children were detected by radioimmunoassay and compared with 30 normal controls. Results There were significant differences in the mean levels of GAS, MTL and IGF-1 among the critically ill children (F = 49.61, 55.18, 18.23 P <0.001), and the levels of GAS, MTL and IGF-1 in the patients with gastrointestinal dysfunction Non-gastrointestinal dysfunction group was significantly different (t = 4.455,4.241,2.672 P <0.001). There was significant difference between MTL and IGF-1 in four organ dysfunction and two organ dysfunction in critically ill children, but there was no significant difference in GAS. The levels of GAS, MTL and IGF-1 in the critically ill children before and after treatment were significantly higher than those in the non-critically ill controls (t = 3.232, 4.352, 4.706 P <0.001). Conclusions Serum levels of GAS, MTL and IGF-1 may be involved in the development of critically ill patients with MODS in critically ill children, and may be associated with gastrointestinal dysfunction and MODS. Combined with the clinical monitoring of GAS, MTL and IGF-1, The estimated severity of illness in children and treatment have important guiding significance.