| Objective: Hypoxic-ischemic brain damage (HIBD), due to asphyxia in perinatal period, is a kind of neonatal brain damage caused by partly or completely hypoxia, and it is common in clinic such as neonatal asphyxia, neonatal hypoxic-ischemic encepholopathy (HIE) and neonatal intracranial hemorrhage (ICH), which is one of the important reasons that lead to acute death of newborns and disability of children. Newborns with HIBD usually accompany manifestations of gastrointestinal dysfunction including gastric retention, emesis, abdominal distention and stress ulcer and so on. Motlin (MTL) and gastrin (GAS) are both the most important gastrointestinal horm ones. They not only relate to all the accommodation of gastrointestinal function, but also to nervous system and many other systems.According to observe the blood MTL and GAS levels after HIBD of term newborns dynamically, we are hoping to explore its effect to central nervous system and its clinical significance.Object and method: object: term newborn with asphyxia 67 cases, mild asphyxia 43 cases and severe asphyxia 24 cases;41eases complicated HIE;26 cases complicated ICH;15 cases complicated both HIE and ICH: and the normal control group with 30 healthy term newborns. We checked MTL and GAS concentration of the observe group in the 2, 3~5, 7-10, 12 ~15 days of age. 4 ml vein blood of all the objects was taken on an emptystomach(8 hours) in the morning, 2 ml was poured into a precooling tube which contained 30 ul 10% EDTA-2Na and 30 ul Aprotinin, then was centrifugal for 20 min at 4°C after intensively mixed, took the plasma and conserved at 20°C for MTL measurement;the other not anticoagulant 2 ml blood was centrifugal for 20 min at 4°C, then took the serum and conserved at 20°C for GAS measurement.We adopted the 125I MTL radioimmunoasssay boxes offered by the East Asia Immunotechnology Institute of PLA General Hospital and 125I GAS radioimmunoasssay boxes offered by Beijing Furi Bioengineering Company, and operated according to the directions strictly;adopted the LDR4-8 4°C refrigerated centrifuge offered by Beijing Clinical Centrifuge Factory to isolate the blood;and the measuring apparatus is the EJ-2003 automatic 6-immuno-counter produced by Xi'an 262 Factory.Statistical treatment: Use SAS6.0 package to deal with all the data, adopt t~test procedure to make group comparison. Data are expressed asmean ± standard variance (x ± s). P<0.05 means that the analysis hasstatistical significance.Results: 1. The blood GAS and MTL concentration of neonatal asphyxia group increased dramatically in the first two days, then began to fall at 3-5 days, but still has significant difference in comparing with the normal control group;the mild asphyxia group regained the normal level at 7-10 days, while the severe asphyxia group still has significant difference (P<0.01);at 12-15 days, some of the severe asphyxia newborns regained normal, but the mean level still has statistical significance compared to the normal control group(P<0.05).2. The blood GAS and MTL concentration of neonatal HIE group increased dramatically in the first 2 days, then began to fall at 3-5 days, but still has significant difference in comparing with the normal control group;the mild HIE group regained the normal level at 7-10 days, while themoderate and severe HIE group still has significant difference (P<0.05);at 12~15days, the moderate and some of the severe HIE newborns regained normal, but the mean level of the severe group still has statistical significance compared to the normal control group(P<0.05).3. The blood GAS and MTL concentration of neonatal ICH group has significant difference in comparing with the normal control group in the first 2 days (P<0.01), then began to fall at 3-5 days, but still has significant difference in comparing with the normal control group (P< 0.01);and still has significant difference (P<0.01) at 7-10 days;at 12~15days, it also has statistical significance compared to the normal control group (P<0.05).Conclusion: 1. The blood MTL and GAS levels in term newborns with HIBD increase during the early period of HIBD, and reach the peak level within 48 hours after birth. The level of the severe newborns increase apparently compared to the mild newborns'.2. The concentration of blood MTL and GAS has relationship with the symptoms and physical condition. The heavier the HIBD is, the longer the high level of blood MTL and GAS lasts.3. The blood GAS and MTL concentration of asphyxia group without HIBD has not statistical significance compared to the normal control group. It indicates that the abnorm excretion of the blood GAS and MTL has close relationship with brain injure.
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