The Evaluation And Analysis Of Gastrointestinal Function After Traumatic Brain Injury In Ghrelin

Objective: The incidence of traumatic brain injury(TBI)is increasing year by year,and there may be gastrointestinal dysfunction due to inflammatory reaction,neuron damage,sympathetic nerve excitation,intestinal ischemia and hypoxia reperfusion injury.Ghrelin is a kind of brain gut peptide hormone,and it is an endogenous growth hormone receptor(GHS-Rs)which has many biological functions such as promoting growth,stimulating food intake,promoting gastric acid secretion,new functions and sleep.Clinically,Ghrelin can play a role both in vivo and in vitro.In this study,the relationship between Ghrelin and gastrointestinal motility disorder(GMD)secondary to TBI was observed through clinical trials.Methods: Sixty patients with TBI who were treated in the Yijishan Hospital of Wannan Medical College from November 2016 to October 2017 and met the inclusion criteria were screened as TBI group.According to the Glasgow score(GCS score),they were divided into mild TBI group(mild group)(GCS score of 12~15points,20 cases),moderate TBI group(moderate group,GCS score of 9~12 points,20cases)and severe TBI group(severe group,GCS score of 3~8 points,20 cases).Another 20 patients of matched age who had scalp masses and relatively smaller benign tumors in non-functional area and without stress were selected as the control group.Serum Ghrelin,gastrin(GAS)and somatostatin(SS)were detected by double-antibody sandwich ELISA.The recovery time of bowel sounds,anal exhausttime and gastric emptying time,gastric emptying rates and abnormal gastric emptying rates at different time were recorded.Results: The levels of serum Ghrelin and SS in severe group at 7 days after injury were higher than those at 12 hours,1 day and 3 days after injury,while the level of GAS was lower than that at 12 hours,1 day and 3 days after injury,with statistically significant differences(P < 0.05).The levels of serum Ghrelin and SS were significantly lower,while GAS levels were higher in severe group than in mild group,moderate group and control group at 12 hours,1 day and 3 days after injury,with statistically significant differences(P<0.05).The recovery time of bowel sounds in severe group was longer than that in mild group,moderate group and the control group(P<0.05),without statistically significant differences among the other 3 groups(P > 0.05).The time of gastric emptying 25%,75% and 95% of severe group after injury was longer than that of the control group,with statistically significant differences(P < 0.05).The gastric emptying rate and abnormal rate of gastric emptying in severe group was lower than that in mild group,moderate group and the control group(P<0.05).There was no GMD in the control group or the mild group,and there was 1 case of GMD(5.0%)in moderate group and 13 cases of GMD(65.0%)in severe group,with significant differences among the 4 groups(P <0.05).There were no significant differences among mild group,moderate group and control group in above indicators(P > 0.05).Conclusion:1 The gastrointestinal hormones decrease with the decrease of plasma Ghrelin in patients with severe TBI,and they begin to recover at 7 days after the operation.2 The probability of GMD secondary to mild and moderate TBI is relatively lower,while the probability of GMD secondary to heavy TBI is relatively higher.