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Clinic Investigation on the Plasma Levels of VIP、MOT and Feeding Intolerance in Preterm Infants

Author: XuZuo
Tutor: LiuGuoSheng
School: Jinan University
Course: Pediatrics
Keywords: vasoactive intestinal peptide motilin preterm infant feeding intolerance
CLC: R722.6
Type: Master's thesis
Year: 2010
Downloads: 34
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Abstract


Objective:Through the determination of the anteprandial level of VIP and MOT on the first day, the fourth day, the seventh day and the fourteenth day of preterm infants who have different gesrational age, the essay intends to study the variation tendency of VIP and MOT and their relationship with feeding intolerance of preterm infants of life within fourteen days, discuss its clinical significance of enternal feeding of preterm infants, thus further explore the relative influencing factors on the feeding intolerance of preterm infants.Method:112 preterm infants are divided into FT group and FI group based on their feeding.There are 59 in group FT and 53 in group FI. Each is divided into three subgroups:GA≤32W(subgroup a),32W<GA≤34W(subgroup b),34W<GA<37W(subgroup c).RIA is used to determine the anteprandial level of plasma VIP and MOT of the preterm infants on the first, fourth, seventh and fourteenth day of life. Meanwhile feeding intolerance are analysed by logistic regression through collecting the clinical prenatal and postnatal materials of the preterm infants. Datas are assessed by SPSS 13.0.Results:①The variation tendency of plasma level of VIP varies with time between group FI and group FT (F=13.89,P=0.000).Plasma level of VIP does not change significantly on each time point in group FT. Plasma level of VIP in group FI increases gradually with time. Plasma level of VIP in group FI is lower than that in group FT (F=71.21, P=0.000).The tendency of changes in plasma level of MOT over time is the same in two groups ((F=2.14, P=0.095),). Plasma level of MOT increases gradually with time and plasma level of MOT in group FI is lower than that in group FT (F=43.48,P=0.000).②Plasma level of VIP in group FIa is lower than that in group FTa on each time point(P<0.05).The difference beteween the two groups has statistical significance. Plasma level of VIP in group FIb is lower than that in group FT b within day 7 of life (P<0.05). The difference beteween the two groups has statistical significance. The difference beteween group FTc and FTc on each time point with the fourteen days of life has no statistical significance (P>0.05).③Plasma level of MOT in group FIa on each time point is lower than that in group FTa after day 14 of life(P<0.05). The difference beteween the two groups has statistical significance. Plasma level of MOT level in group FIb and FIc is lower than those in group FTb and FTc respectively after day 4 of life. The difference beteween the two groups has statistical significance. The difference between the fourth day and the fourteenth day has no statistical significance (P>0.05).④Feeding quantity is increased with the increase of the plasma level of VIP and MOT after day 7 of life (r>0,P<0.05). Feeding quantity and plasma VIP and MOT level show positive liner relationship. On day 14 after life, plasma level of MOT presents positive correlation with the feeding quantity (r=0.45,P< 0.05) while plasma level of VIP presents negative correlation with the feeding quantity (r=-0.18, P=0.057).There is no statistical significance between them until now.⑤The younger the gestational age, the longer the feeding intolerance. The difference of plasma level of VIP and MOT on day 1 of life between any group and other group has statistical significance (F=125.95,21.25, P<0.05. It indicates that plasma level of VIP and MOT of the preterm infants increases with their gestational age.⑥Gestational age, using of glucocorticoids in antenatal are the protective facors for feeding tolerance through the logistic regression. Fetal distress placental abnormality and perinatal infection are the dangerous factors for feeding intolerance.Conclusion:①the relation between gestational age and the plasma level of VIP and MOT is close.The lower the gestational age is, the longer the feeding intolerance is. The plasma level of VIP and MOT of preterm infants after day 1 of life contributes to the possibility of feeding intolerance as soon as possible. It is worth exporing the reasonable enternal feeding plan based on the plasma level of VIP and MOT. Plasma level of VIP does not change significantly with days for the preterm infants with feeding tolerance. Plasma level VIP of preterm infants with feeding intolerance is lower than that of plama level of ptrterm infants with feeding tolerance and jumps with days of life. Feeding improves with the enteral nutrition. Plasma level MOT of preterm infants with feeding intolerance is lower than that of plama level of preterm infants with feeding tolerance and they both jump with days of life.②The lower the gestational age is, the higher the feeding intolerance is. Using of glucocorticoids in antepartum can decrease the possibilities of feeding intolerance. The preterm infants with fetal distress, placental abnormality and perinatal infection are prone to feeding intolerance.

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CLC: > Medicine, health > Pediatrics > Newborns, premature children disease > Preterm children disease
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