| Objective: Diamine oxidase (DAO) existes in the mammalian mucosa orfluff layer, most of which were present in the small intestine mucosal villous,while rarely exists in the uterine villi. DAO is a high active intracellularenzymes, whose activity and the villus height are closely related to mucosalcell nucleic acid and protein synthesis. DAO is a reflection of the structure ofsmall intestinal mucosa function of ideal index. The total DAO of tissue andplasma comes from two ways, one is necrosis of intestinal mucosa cells fromfalling into the intestinal lumen, by which way the intestinal DAO activitydecreased, the other is the elevated plasma DAO caurse of the intestinal cellgap lymphatic and blood flow. Therefore, in clinical and experimental animalstudies, by determinning the DAO activity of intestinal tissue and bloodchanges, can reflect the intestinal mucosal barrier function, particularly in thenoninvasive determination of blood DAO activity circumstance, which canreflect the situation of intestinal injury and repair. Fatty acid binding protein(FABP) is a group of low molecular weight (about15kD) in combination witha long chain fatty acid binding protein, which has the tissue specificity.It issuggested that FABP locals at mammalian myocardium, intestine, liver,adipose tissue, brain, skin, whom is a monitoring of tissue injury in emergingand a very valuable biological index. It is currently used in chronic heartfailure (H-FABP), liver allograft rejection (L-FABP), non-heart-beating donorkidney survival selection (H-FABP, L-FABP), professional athlete's muscleinjury prevention (S-FABP). Intestinal fatty acid binding protein (I-FABP) isone of the nine different types of the FABP in the current foundings. I-FABPderives from intestinal epithelial cell cytoplasm, which mainly located at theintestinal microvilli tip. The current clinical studies reported that I-FABP can be used as a diagnosis and ischemia index of early intestinal mucosal damage.The aim of the experiment is to study the degree of different chemotherapy inpediatric injury on the intestinal mucosal barrier function, by measuring thelevels of plasma amine oxidase (DAO) and intestinal fatty acid binding protein(I-FABP), before chemotherapy and after.Methods:According to the different emetogenic intensity ofchemotherapy medicine, the children who were given repeated chemotherapywere divided into3groups (mild emetogenic group, moderately emetogenicgroup, highly emetogenic group). We acquised the plasma of everychemotherapy children at different time,before and after(before chemotherapy,three days after, seven days after), and determinated the plasma level of DAOand I-FABP. The way wass using the application of enzyme linkedimmunosorbent test method and colorimetric method. At the same time, werecorded the vomiting times of pediatric patients during chemotherapy even ifthe routine application of antiemetic was given, and collected daily freshspecimen to smear and to Gram stain, reading and calculate the proportion oftuberculosis/total in the high magnification.The measurement data was used the mean addition or subtraction SD(X±S), while count data was used the relative ratio to display.Theexperimental data were analyzed by SPSS13.0software. The inspection levelof α was0.05. P<0.05was considered had a statistically significant difference.Results:1.The comparison of the DAO level among the differentemetogenic chemotherapy groups:(1)Before chemotherapy was given, theplasma level of DAO among the different emetogenic strength group wasequal, no significant difference existed between any two of them(P>0.05);(2)Three days and seven days after chemotherapy, there was asignificant difference (P<0.05) between any two of the three emetogenicstrength groups, what,s more,the high-emetogenic group was significantlyhigher than the other two groups;(3)The levels of plasma DAO of the threegroups at three days and seven days after chemotherapy was given weresignificantly higher than that before chemotherapy was given(P<0.05), and the levels of three days after chemotherapy were significantly higher than that ofthe seven days after(P<0.05)；2.The comparison of the I-FABP level amongthe different emetogenic chemotherapy groups:(1)Before chemotherapy wasgiven, the plasma level of I-FABP among the different emetogenic strengthgroup was essentially flat, no significant difference between any two of them(P>0.05);(2)Three days after chemotherapy and seven days after, there was asignificant difference (P<0.05) between any two of the three emetogenicstrength groups, what,s more,the high-emetogenic group was significantlyhigher than the other two groups;(3)The levels of plasma I-FABP of the threegroups at three days and seven days after chemotherapy was given aresignificantly higher than that before chemotherapy was given(P<0.05), and thelevels of three days after chemotherapy were significantly higher than that ofthe seven days after(P<0.05)；3.The comparison of vomiting times among thedifferent emetogenic chemotherapy groups:(1)Comparing of vomiting timesamong the different emetogenic chemotherapy groups, the high groups wasmore than the other two groups, and the moderate groups was more than thatof the low groups. But there was no statistically difference(P>0.05).(2)Thevomiting times of the highly emetogenic chemotherapy group reached thepeak at the third day, while the other two groups reached the peak later, at thefourth day；4.The ralation between vomiting times and plasma DAO andI-FABP:(1)Vomiting times and the level of DAO has positive correlation,there is a statistically difference(r=0.744,P<0.05)；(2) Vomiting times andthe level of I-FABP has positive correlation, there is a statistically difference(r=0.889,P<0.05);(3)At the third day, the level of DAO and I-FABP ofhigh vomiting times group was higher than that of low group(P<0.05). Whileat the seventh day, no difference exsited between the two groups(P<0.05)；5.The comparison of bacteria bacillus/total among the different emetogenicchemotherapy groups:Comparing of bacteria bacillus/total among the differentemetogenic chemotherapy groups, the high groups was less than the other twogroups, and the moderate groups was less than that of the low groups. Butthere was no statistically difference(P>0.05)；6.The ralation between bacteria bacillus/total and plasma DAO and I-FABP:(1) Bacteria bacillus/total and thelevel of DAO has negative correlation, there is a statistically difference(r=-0.180,P<0.05)；(2) Bacteria bacillus/total and the level of I-FABP hasnegative correlation, there is a statistically difference(r=-0.222,P<0.05).Conclusion:1. The levels of plasma DAO and I-FABP increased after three days andseven days were significantly higher than that before chemotherapy wasgiven. The level of plasma DAO and I-FABP of high vomiting group washigher than that of low group. It indicated that different degree ofgastrointestinal mucosal barrier injury exist at all Chemotherapy childreninduced by chemotherapeutic drugs, and the higher spit strength increases,the more serious the intestinal mucosal damage was, and also the higherconcentration the plasma DAO and I-FABP levels was.2. The level of plasma DAO and I-FABP caused by chemotherapy haspositive correlation with vomting times. It indicated that they can reflectthe status of intestinal mucosa of tumor patients after chemotherapy wasgiven.3. The level of plasma DAO and I-FABP has negative correlation withbacteria bacillus/total. It indicated that the more serious the gastrointestinalinjury caused by chemotherapy, the more obvious of imbalance ofintestinal flora will be. |
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