胃肠激素在早期肠内营养预防应激性溃疡的表达研究  

The expression of gut hormone in the prophylactic effect of early enteral nutrition on stress ulcer

作　　者：王旦[1] 吴建胜[1] 黄增相[1] 吴金明[1] 黄智铭[1] 

机构地区：[1]温州医学院附属第一医院,浙江温州325000

出　　处：《山东医药》2008年第1期44-46,共3页Shandong Medical Journal

摘　　要：目的探讨胃肠激素在早期肠内营养预防应激性溃疡的作用。方法将38例危重患者随机分为3组:A组13例,给予抑酸药物加早期(发病24 h内)肠内营养;B组13例,给予抑酸药物加延迟(发病72 h后)肠内营养;C组12例,单纯应用抑酸药物。于发病后5 d、2周时分别行胃镜检查,观察溃疡的发生情况;同时测定各组前列腺素(PGE-2)和胃泌素(GAS)、生长抑素(SS)的含量。结果A组溃疡发生率及溃疡指数均明显低于B、C组(P<0.01),溃疡抑制率高于其他两组(P<0.01);A、B组2周后溃疡愈合率高于C组(P<0.05)。与B、C组比较,A组胃黏膜中的PGE-2、GAS水平明显增高,SS水平明显降低(P<0.05);B、C组间亦有统计学差异(P<0.05)。结论应用抑酸药物同时给予早期肠内营养治疗可能对应激性溃疡的发生有一定的预防作用。肠内营养可能通过调节胃肠激素含量起作用。Objective To study the mechanism of the prophylactic effect of early enteral nutrition （EEN） on stress ulcer and the expression of gut hormone. Methods 38 critical patients were randomly divided into three groups. Group A was treated by acid suppression （AS） together with early enteral nutrition （EEN）, group B was treated by AS together with delayed enteral nutrition （ DEN）, and group C was treated by AS alone. The incidence and gradation of the ulcer were observed, and the contents of the prostaglandin E2 （PGE-2） and gastrin （ GAS）, somatostatin （SS） in the gastric mucosa were tested by the gastroscopy 5 days later and two weeks later. Results The ulcer incidence rate of group A was lowest of the three groups while its inhibition ratio is highest（ P 〈 0.01 ）. After two weeks the cure rate of group C was lower than A or B （ P 〈 0.05 ）. The levels of PGE-2 and GAS in the mucosa of group A were both higher than B or C, while the level of SS was lowest （P 〈 0.05 ）. There was also significant difference between B and C （ P 〈 0.05 ）. Conclusions EEN can avoid the stress ulcer more efficiently. PGE-2 and GAS, SS may play an important role in the process.

关 键 词：早期肠内营养 应激性溃疡 前列腺素 胃泌素类 生长抑素 

分 类 号：R573.1[医药卫生—消化系统]