手術病人在急性和慢性營養不良下會增加疾病的罹患率及死亡率。營養評估是醫療過程中一項非常重要的工作，尤其生化檢驗更是被認為最客觀且量化的營養評估方法。纖維網狀蛋白可當作營養不良急性指標；它在細胞外間質中視為一個非常重要的成分，與細胞接著、分化、移動及傷口癒合方面都有密切的關係。本篇研究目的即要探討重症病人於術前、術後血中纖維網狀蛋白濃度的變化。研究對象為20位健康成年人與 30 位手術病人依手術部位之不同隨機分成二組，分別為腦部、腹部等。研究方法以單一特異性的纖維網狀蛋白抗體進行酵素接合免疫吸附分析法(enzyme-linked immunosorbent assay；ELISA)來檢測血漿中纖維網狀蛋白的濃度。結果顯示健康成年人纖維網狀蛋白平均濃度為44.05 ±3.25mg/dl，手術前腦部、腹部二組纖維網狀蛋白平均濃度分別為31.37±11.95mg/dl及16.14±8.73mg/dl，手術後第一天分別為26.88±10.3 mg/dl、11.52±3.54 mg/dl，以上結果顯示術後第一天血中纖維網狀蛋白的濃度快速且顯著的下降，給予營養補充後其纖維網狀蛋白濃度可回復到術前之濃度，證實纖維網狀蛋白可用於醫院急性營養耗損病人的臨床營養指標。
Surgical treatments with acute and chronic malnutrition increase morbidity & mortality in patients. Nutritional assessment plays an important role in the medical process, in which biochemistry examination is the most objective quantitative assessment of the nutrition status. Fibronectin can be used as a parameter of acute malnutrition assessment, because fibronectin is an important component in the extracellular matrix family, which relates to cell adhesion, differentiation, migration, and wound healing. The purpose of this study was to investigate the change of plasma fibronectin in patients with pre-operative and post-operative critical ill.
Twenty healthy adults and 30 patients underwent cranial and abdominal operation were randomly divided into 2 groups. By using specific antibody to fibronectin, the plasma concentration of fibronectin,was determined by ELISA method. The results showed concentration of fibronectin in healthy adults: was 44.05±3.25 mg/dl , and the concentration of fibronectin in pre-operative cranial and abdominal surgical patients were 31.37±11.95mg/dl and 16.14±8.73mg/dl, respectively. The first day of post operation: in cranial and abdominal surgical patients were 26.88±10.3mg/dl and 11.52±3.54mg/dl , respectively.The data showed that the rapid and significant decline of fibronectin in the first day of post operation could be resume to pre-operation status after in-time nutritional support. This study also supports that plasma fibronectin level is a good indicator for nutritional assessment for surgical patients.
