血浆纤维粘连蛋白测定对判断肺源性心脏病预后的意义

CLINICAL SIGNIFICANCE OF PLASMA FIBRONECTIN DETERMINATION IN THE PATIENTS WITH CHRONIC COR PULMONALE

采用免疫单向扩散法检测了肺源性心脏病(急性期、缓解期和恶化期)58例,慢性支气管炎20例及风湿性心脏病10例患者血浆纤维粘连蛋白(Fibronectin,FN)含量。60例健康成人作为对照组。分析了血浆FN含量和呼吸衰竭、感染程度及不同类型酸碱紊乱的关系。结果表明:对照组血浆FN含量为322.4±60mg/L,慢性支气管炎组为363±40mg/L,风湿性心脏病组为333.5±48mg/L。肺源性心脏病急性期FN明显降低,平均为146±67mg/L;缓解期逐渐恢复(286±62 mg/L);恶化期则极度降低(101±39mg/L)。重度呼吸衰竭、肺部感染和酸碱失衡者,FN均明显降低。作者认为:血浆FN可作为肺源性心脏病患者估价病情和预后的一项可靠指标。FN减低的原因可能与肺源性心脏病患者急性期和恶化期消耗增加和合成减少有关。

Plasma fibronectin(FN) level was measured by single radial immunod if fusion method in 58 patients with chronic Cor pulmonale during acute, remission and deterioration stages, 20 cases of chronic bronchitis, 10 cases of rheumatic heart disease, and 60 healthy people as controls.We analysed the relationship between the changes of plasma FN level and the degree of the respiratory failure, pulmonary infection and acid-base disturbance in experimental groups.The results showed that plasma FN levels of the controls, and the patients with chronic bronchitis and rheumatic heart disease were 322.4±60mg/L,263±40mg/L and 333.51 48mg/L, respectively.Plasma FN level was significantly decreased in patients with Cor pulmonale during acute stage(l46±67mg/L), gradually restored at remission stage (286±62mg/L) and markedly decreased in deterioration stage (101±39mg/L).It was ako markedly decreased in the patients with severe respiratory failure, pulmonary infection and acid-base disturbance.The authors suggest thai: placma FN may be used as a valuaole parameter to evaluate the clinical severity and prognosis of the patients with Cor pulmonale.The decrease of plasma FN level in patients with chronic Cor pulmonale may be due to its increased consumption and decreased synthesis in acute and deterioration stages.