Clinical Investigation On The Plasma Levels Of Ghrelin,CCk And Feeding Intolerance In Preterm Infants

Objective: To investigate the relationship of feeding intolerance with their plasma level ofghrelin and CCK in preterm infants，probe the correlation factors on the feeding intolerance ofpreterm infants.Method:81preterm infants were divided into FI and FT group (FI group:45cases, FT group:36cases). Each group was classified as three subgroups: GA＜32W（subgroup A）,32W≤GA＜34W（subgroup B）,34W≤GA＜37W（subgroup C）and their plasma ghrelin and CCK level at1st,3rdand7thday were measured by using ELISA，then investigate the relationship of feedingintolerance with their plasma level of ghrelin and CCK. The sample means of two groups wereanalyzed by independence-sample t-test, multiple sample means of groups were analyzed byone-way ANOVA, and measurement datas were recorded as mean±S.E.（x±s）, rates werecompared by Chi-square test. We used repeated measures to compare among different groups.Collect the clinical prenatal and postnatal materials of the preterm infants who entered theresearch, and analyzed feeding intolerance with the datas by logistic regression. Datas wereanalyzed by SPSS17.0.Result:①On1st,3rdday of life, the plasma ghrelin level of group FI was lower than that ofgroup FT（F=50.462，P=0.000）; the less of gestational age, the lower the plasma ghrelin level;the plasma ghrelin level increased with the days of postnatal（F=288.225，P=0.000）; on7thday,the plasma ghrelin level had no significant different between the subgroup FI-A and FT-A（P＞0.05）.②The less of gestational age, the easier underwent FI, and the longer FI would continue;the time of FI continued was negative linked with the plasma ghrelin level on1stday（r＜0，P=0.000）.③The plasma ghrelin level was linked with feeding quantity（r＞0, P＜0.05）; thehigher of the ghrelin level, the more of feeding quantity.④The plasma CCK level decreasedwith the days of postnata（lF=718.465，P=0.000）; the plasma CCK level of group FI was higherthan that of group FT（F=43.84，P=0.000）; the less of gestational age, the lower of CCK level(P＜0.05); in the infants whose gestational age were more than34weeks，the CCK level of groupFI is higher than that of the group FT on1stday, but on3rdand7thday, there were no significantdifferences between the group FI and FT.⑤The correlation factors of FI: logistic regression discovered that the infants with anemia or perinatal infection had higher risk of FI, and theinfants with larger birth weight or using glucocorticoids in antenatal had lower risk of FI.Conclusion:①The plasma level of ghrelin and CCK had close relationship with FI of preterminfants; the lower of the plasma ghrelin level, the easier FI would occur, and the longer FI wouldcontinued; the higher of the plasma CCK level, the easier FI would occur.②The plasma ghrelinand CCK level were linked with gestational age and birth weight, the less of gestational age andbirth weight, the lower of plasma ghrelin and CCK level.③The infants with anemia or perinatalinfection had higher risk of FI.