Value of gastrointestinal hormone levels in judgment of prognosis of critically ill children with gastrointestinal dysfunction

  Objective  To explore the value of changes of gastrointestinal hormone levels in judgment of prognosis of critically ill children with gastrointestinal dysfunction.

  Methods  A total of 696 critically ill children with gastrointestinal dysfunction were enrolled in this study. After admission, they were given routine treatment, including anti-infection, mechanical ventilation, maintenance of internal environment, protection of gastrointestinal mucosa, nutritional support and other treatments. The blood samples of all enrolled children were collected to detect gastrointestinal hormone[gastrin (GAS), motilin (MOT), somatostatin (SS)] and inflammatory indexes [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)]. Gastrointestinal dysfunction score (SNGF) was used to evaluate degree of gastrointestinal dysfunction and the patients were divided into mild group (SNGF score < 2), moderate group (SNGF score ranging from 2 to 4) and severe group (SNGF score>4).

  Results  There were no significant differences in gastrointestinal hormone levels between the mild group and the moderate group (P>0.05). The GAS and MOT levels in the severe group were significantly lower, and the SS level in the severe group was significantly higher than those in the mild illness group and the moderate group (P < 0.05). IL-6 and TNF-α levels in the mild illness group showed significant differences compared with the moderate group (P>0.05), and were significantly higher in the severe group than those in the mild illness group and the moderate group (P < 0.05). The level of CRP in the moderate group was significantly higher than that in the mild group, and was significantly higher in the severe group than that in the moderate group (P < 0.05). IL-6, TNF-α and CRP levels were positively correlated with SS (P < 0.05), and negatively correlated with GAS and MOT (P < 0.05). The levels of GAS and MOT of surviving children were higher, and the levels of SS were lower than those of the death (P < 0.05).

  Conclusion  The level of gastrointestinal hormone can reflect the severity of gastrointestinal dysfunction to some extent, and has especial value in judgment of prognosis of children with severe gastrointestinal dysfunction.