Jain L, DelValle J, Gelhar D, Levy P, McCulloch K, Vidyasagar D
Department of Pediatrics, University of Illinois, Chicago, USA.
Biol Neonate. 1995;68(2):81-6. doi: 10.1159/000244221.
To determine the chronology of postnatal somatostatin (SRIF) changes in preterm infants and the relationship of SRIF levels to respiratory and gastrointestinal complications, we evaluated sequential SRIF levels in 62 preterm infants in the first month of life. Weekly preprandial plasma samples were obtained and analyzed for SRIF using a radioimmunoassay. Additional blood samples were obtained at the time of abdominal events. Somatostatin levels were highest in week 2 and gradually declined in weeks 3 and 4 (mean +/- SD pmol/l, SRIF = 92.3 +/- 30.3 in week 2 vs. 79.8 +/- 33.9 in week 3 and 69.7 +/- 54.4 in week 4, p < 0.03). Birth weight, gestational age and sex were not related to initial SRIF levels. Infants with respiratory distress requiring assisted ventilation had significantly higher week 1 SRIF levels compared to infants without respiratory problems (97.9 +/- 22.7 vs. 74.9 +/- 21 pmol/l, p < 0.02). Twenty-one of the 62 infants had gastrointestinal complications. Somatostatin levels preceding (89.0 +/- 25.9 pmol/ 1), during (91.0 +/- 13.3) and after (79.3 +/- 28.6) the gastrointestinal events were not significantly different, nor were they different from SRIF concentrations of age-matched preterm infants without gastrointestinal complications. The results suggest that in preterm infants, postnatal SRIF changes follow a definite pattern with peak concentrations in week 2. Respiratory distress is associated with a significant increase in SRIF. However, subsequent gastrointestinal events do not lead to an increase in SRIF. This lack of SRIF response in gastrointestinal stress may play a role in the pathogenesis of gut injury in the premature neonate.
为了确定早产儿出生后生长抑素（SRIF）变化的时间顺序以及SRIF水平与呼吸和胃肠道并发症的关系，我们评估了62例早产儿出生后第一个月内SRIF的连续水平。每周餐前采集血浆样本，采用放射免疫分析法分析SRIF。在发生腹部事件时采集额外的血样。生长抑素水平在第2周最高，在第3周和第4周逐渐下降（均值±标准差，pmol/l，第2周SRIF = 92.3±30.3，第3周为79.8±33.9，第4周为69.7±54.4，p < 0.03）。出生体重、胎龄和性别与初始SRIF水平无关。与无呼吸问题的婴儿相比，需要辅助通气的呼吸窘迫婴儿第1周的SRIF水平显著更高（97.9±22.7 vs. 74.9±21 pmol/l，p < 0.02）。62例婴儿中有21例发生胃肠道并发症。胃肠道事件发生前（89.0±25.9 pmol/l）、期间（91.0±13.3）和之后（79.3±28.6）的生长抑素水平无显著差异，也与无胃肠道并发症的年龄匹配早产儿的SRIF浓度无差异。结果表明，早产儿出生后SRIF变化遵循一定模式，第2周浓度达到峰值。呼吸窘迫与SRIF显著升高有关。然而，随后的胃肠道事件并未导致SRIF升高。胃肠道应激时SRIF缺乏反应可能在早产儿肠道损伤的发病机制中起作用。
