危重症患儿血浆纤维连接蛋白含量变化及其意义

探讨危重症患儿血浆纤维连接蛋白（Ｆｎ）的变化特点及其意义。测定７５名危重患儿Ｆｎ含量。结果显示：其值（１６０．４２±７８．１８ｍｇ／Ｌ）明显下降，与正常儿童的Ｆｎ含量（２５９．３０±３４．６８ｍｇ／Ｌ）相比有显著性差异（ｔ＝５．１１１，Ｐ＜０．０１）；呼吸衰竭、全身感染和中枢神经系统疾病时Ｆｎ均有降低；另外，２２例门诊或中度呼吸道感染的患儿Ｆｎ与正常儿童相比无显著性差异（ｔ＝１．８７１，Ｐ＞０．０５），而与危重症患儿相比差异有显著性（ｔ＝５．４０９，Ｐ＜０．０１）；严重呼吸衰竭需机械通气患儿Ｆｎ含量比呼吸衰竭不需机械通气患儿Ｆｎ降低更明显；而感染性休克患儿Ｆｎ比未合并休克患儿的Ｆｎ减低更明显。所以，小儿危重症时Ｆｎ降低主要与疾病的严重程度有关，Ｆｎ若持续降低，则提示预后不良，Ｆｎ可作为判定疾病严重程度和病情转归的指标之一，也可作为临床Ｆｎ替代治疗的一个指征

Plasma concentrations of fibronectin in critically ill children

Plasma fibronectin (Fn) was tested in 75 critically ill children and 22 outpatients with mild or moderate respiratory infection.Plasma Fn in the 75 critically ill children was obviously reduced and was found to be significantly different from that in normal children( t =5 111, P <0 01)and the 22 outpatients( t =5 409, P <0 01).No significant difference in plasma Fn existed beween normal children and the 220 outpatients( t =1 871, P >0 05).Plasma Fn was decreased in respiratory failure(RF),systemic infection and disease of central nervous system(CNS).Plasma Fn in severe RF patients who needed mechanical ventilation(MV) was more significantly decreased as compared with RF patients whe did not need MV.Similarly,septic shock patients were found to have a much lower plasma Fn than patients without shock.The results showed that the reduction of plasma Fn was related to the severity of the disease.Persistent decrease of plasma Fn suggests poor prognosis.Thus,plasma Fn concentration is of prognostic value,and may be considered as an index of exogenous Fn replacement therapy.