肠外高营养对重症溃疡性结肠炎患者一些脑肠肽和免疫蛋白的影响及临床意义  

Effects and Clinical Significance of Parenteral Hyperalimentation on Serummotilin,Peptide YY, IgG and Glycoproteins in Severe Ulcerative Colitis

作　　者：许昌泰[1] 郭学刚[2] 孙安华[2] 李彩宁[2] 张宏博[2] 周新民[2] 潘伯荣[2] 

机构地区：[1]第四军医大学学报编辑部,陕西西安710032 [2]第四军医大学西京医院全军消化病研究所,陕西西安710032

出　　处：《中国误诊学杂志》2005年第3期401-403,共3页Chinese Journal of Misdiagnostics

基　　金：陕西省卫生厅基金资助项目(编号:2004D26)

摘　　要：目的研究肠外高营养对重症溃疡性结肠炎患者一些脑肠肽和免疫蛋白的影响并讨论其临床意义。方法重症溃疡性结肠炎患者119例,病变包括乙状结肠55例,降结肠31例,结肠脾曲20例和横结肠13例;临床类型包括复发型54例,持续型40例和初发型25例。采取肠外静脉补充足够的营养,完全胃肠道休息。用放射免疫法(RIA)测定血清胃动素(MTL),肽YY(PYY)和IgG,用血清电泳法测定α1,α2和γ糖蛋白,同时复查纤维肠镜。结果经过4周治疗后临床痊愈36例(30.3%),好转65例(54.6%),无效18例(15.1%),总有效率84.9%。与对照比较,重症溃疡性结肠炎患者血清MTL(P<0.01),PYY(P<0.05),IgG(P<0.01和α1球蛋白(P<0.01)明显升高,而α2球蛋白(P<0.05)则降低,但经过治疗后可恢复。血清白蛋白治疗后明显好转(P<0.01),组织学也明显改善。结论重症溃疡性结肠炎肠外静脉高营养疗法是一种有效可行的方法,且可以改善血清MTL,PYY,IgG和α1,α2糖蛋白水平,同时可以促进组织学恢复。Objective:To study clinical significance and effects of parenteral hyperalimentation on contents of serum motilin, peptide YY, IgG and glycoproteins in patients with severe ulcerative colitis.Methods:The patients with severe ulcerative colitis (n=119) were finally diagnosised. There were located in lesion locus including sigmoid (n=55), descending colon (n=31), colon splenic flexure (n=20) and transverse colon (n=13). The disease processes were in relapse (n=54) , continuing(n=40) and initial (n=25). Gastroin testinal tract rested completely during parenteral hyperalimentation. Serum motilin (MTL),peptide YY (PYY) and IgG ware determinated by radioimmunoassy, and serum α1,α2 and γ glycoproteins by electrophoresis method, and histology ware determinated.Results:After 4 weeks of therapy, there was a full recover from the illness (n=36, 30.3%), taking a turn for the better (n =65,54.6%) and inefficiency (n=18, 15.1%), and the total effective rate were 84.9%. In colitis patients, the serum MTL(P<0.01), PYY(P<0.05), IgG (P<0.01) and α1-glycoprotein (P<0.01) were higher significantly, but α2-glycoprotein(P<~0.05) was lower than controls.After therapy, above-mentioned data returned to normal,and the serum albumin increased(P<0.01),and the histology improved significantly.Conclusion:The parenteral hyperalimentation therapy was an effective method of treatment for patients with severe ulcerative colitis,and could improve the contents of serum motilin,peptide YY,IgG and glycoproteins, and could enhance the histological recovery.

关 键 词：重症溃疡性结肠炎 患者 血清 治疗后 脑肠肽 临床意义 MTL 结论 对照比较 水平 

分 类 号：R574.62[医药卫生—消化系统] R446[医药卫生—内科学]