胃肠激素及细胞因子水平对轮状病毒性腹泻发病机制及病情进展的预测价值  

Predictive significance of serum levels of gastrointestinal hormones and cytokines for disease progression in patients with rotavirus diarrhea

作　　者：吴伟民[1] 吴会超[2] 许晴晴[1] 聂军[1] 

机构地区：[1]贵州省遵义市第一人民医院消化内科,贵州省遵义市563002 [2]遵义医学院附属医院消化科,贵州省遵义市563002

出　　处：《世界华人消化杂志》2013年第30期3296-3300,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨轮状病毒性腹泻患者体内胃肠激素和细胞因子的变化及其对腹泻的早期预测价值.方法:采用ELISA酶联免疫法空腹测定65例不同疾病时期、不同病程及不同疾病程度的轮状病毒感染患儿及60例正常健康儿童中血清中5-羟色胺、血管活性肠肽(vasoactive intestinal peptide,VIP)、胃泌素(gastrin,GAS)、胃动素(motilin,MOT)以及细胞因子[内皮素、白介素(interleukin-10,IL-10)]水平.结果:胃肠急性期血清中5-羟色胺(1942.3g/L±512.3 g/L)、VIP(626.3 g/L±271.2g/L)、GAS(1232.9 g/L±212.3 g/L)、MOT(569.3 g/L±81.5 g/L)、内皮素(59.6g/L±11.7 g/L)、IL-10(11.4 g/L±11.9 g/L),与对照组比较除IL-10下降外,其他均升高,差异有统计学意义(P<0.05);其中重型腹泻5-羟色胺(2563.3 g/L±418.6 g/L)、VIP(728.9g/L±245.3 g/L)、MOT(578.3 g/L±73.9g/L)、内皮素(54.6 g/L±10.7 g/L)高于轻、中型,而中型5-羟色胺(1789.6 g/L±385.2 g/L)、VIP(452.6 g/L±112.4 g/L)、MOT(578.3 g/L±73.9 g/L)、内皮素(37.9g/L±12.2 g/L)高于轻型,差异有统计学意义(P<0.05),而中重型血清中GAS(1214.7 g/L±212.5 g/L)、IL-10(30.8 g/L±4.8 g/L)与轻型(1189.6 g/L±208.2 g/L)、(34.2 g/L±11.4 g/L)无统计学意义(P>0.05).急性期中腹泻时间>3 d者血清中5-羟色胺(2296.3 g/L±456.8 g/L)、VIP(852.6 g/L±178.2 g/L)、内皮素(57.3 g/L±11.2 g/L)、IL-10(41.6 g/L±11.4 g/L),腹泻时间<3 d者分别是(1772.3g/L±245.3 g/L)、(428.6 g/L±105.3 g/L)、(29.6 g/L±11.4 g/L)、(30.8 g/L±10.6g/L),急性期中腹泻时间>3 d以上给出指标均大于腹泻时间<3 d者,而GAS、MOT水平无统计学意义(P>0.05).结论:轮状病毒性腹泻病理生理的改变可能与胃肠激素水平及细胞因子水平的改变有关,通过对相关的胃肠激素及细胞因子水平的测定能有效预测轮状病毒病情的进展.AIM： To assess the early predictive value of serum levels of gastrointestinal hormones and cytokines in patients with rotavirus diarrhea. METHODS： Serum levels of 5-serotonin, vasoactive intestinal peptide （VIP）, gastrin （GAS）, motilin （MOT） and cytokines （endothelin, IL-10） were determined by enzyme-linked immunosorbent assay （ELISA） in 65 children with severe, moderate or mild rotavirus infection during acute or convalescent phase and 60 normal healthy children. RESULTS： Serum levels of 5-serotonin, VIP, GAS, MOT, and endothelin were significantly higher and that of IL-10 was significantly lower in children with rotavirus infection during the acute phase than in normal control controls （all P 〈 0.05）. Serum levels of 5-HT, VIP, MOT, and endothelin were significantly higher in patients with severe rotavirus infection than in those with moderate or mild rotavirus infection （all P 〈 0.05）. Serum levels of GAS and IL-10 showed no significant difference between patients with moderate rotavirus infection and those with mild disease （P 〉 0.05）. Serum levels of 5-serotonin, VIP, endothelin and IL-10 were significantly higher in patients with acute phase rotavirus infection having diarrhea 〉3 d than in those having diarrhea 〈3 d （all P 〈 0.05）, while GAS and MOT levels were not statistically significant between the two groups （both P 〉 0.05）. CONCLUSION： Pathophysiological changes in rotavirus diarrhea may be associated with the changes in serum levels of gastrointestinal hormones and cytokines. The relevant gastrointestinal hormones and cytokines may be used to predict rotavirus disease progression.

关 键 词：胃动素 胃泌素 血管活性肠肽 轮状病毒腹泻 

分 类 号：R725.1[医药卫生—儿科]