Changes in levels of gastrointestinal hormones in patients with stroke (Zhongzangfu,中脏腑) complicating stress gastrohemorrhage in acute stage / 中国中西医结合急救杂志

ABSTRACT

Objective:To observe the dynamic changes in serum gastroanteric hormones in patients with stroke complicating stress upper gastrointestinal hemorrhage in acute stage,the changes in acidity,and the changes in gastric empty and to investigate the pathogenetic link of stress pathological change of gastric mucous membrane in patients with stroke(Zhongzangfu,ZZF,中脏腑).Methods:In 20 cases with acute ZZF (Glasgow coma score 6-12 scores) who were all complicating upper gastroenteric bleeding within 24 hours of attack,the levels of motilin(MTL),somatostation(SS),and gastruins(GAS) were measured by radioimmunoassay at the first day (within 24 hours) and the fourth day (within 72-96 hours) respectively meanwhile the gastratube was plased and kept within 24 hours of attack to dynamically observe the pH of gastric juice and the condition of gastric emptying.Results:In comparison with control group the MTL level was significantly increased in patients at the first day of attack (P<0.05),the SS level significantly decreased (P<0.01),and the GSA level had not significant difference (P>0.05).Otherwise the pH (2.87±0.90） of gastric juice in comparison with control group has not significant difference (P>0.05).Among patients in 17 cases the gastric emptying time was prolonged.Even at the fourth day in patients the MTL level was still significantly increased (P<0.01),SS level decreased (P<0.05),and GAS level increased (P<0.01).Conclusions:The upper gastrointestinal hemorrhage in patients with acute ZZF is tightly associated with the changes in MTL and SS but the changes in GAS and gastric pH are not main factor.