Hughes R D, Imawari M, Bihari D, Almasio P L, Langley P G, Williams R
Eur J Clin Invest. 1986 Oct;16(5):352-6. doi: 10.1111/j.1365-2362.1986.tb01008.x.
Patients with fulminant hepatic failure have low levels of the plasma opsonizing protein fibronectin together with cardiovascular disturbances similar to those in septic shock where microembolization of capillary beds by particulate debris has been proposed to lead to multi-organ failure. Six patients with fulminant hepatic failure received a bolus injection of a concentrated fibronectin-rich preparation. The mean plasma immunoreactive fibronectin level increased from 53 +/- SE 12 micrograms ml-1 initially to 295 +/- 30 micrograms ml-1 (P less than 0.001) at 1 h after fibronectin administration. The in vitro plasma opsonic activity was also increased from 5.6 +/- 3.6% of control to 102 +/- 13% (P less than 0.005) at 1 h. No similar effect was observed with the clearance of microaggregated albumin, but as its clearance is probably not dependent on fibronectin it may reflect a different aspect of reticuloendothelial cell function. No significant changes were observed in cardiopulmonary function or oxygen utilization and it is possible this is because clearance of opsonized particles is limited by damage to Kupffer cells.
暴发性肝衰竭患者血浆调理素蛋白纤连蛋白水平较低，同时伴有与感染性休克相似的心血管紊乱，在感染性休克中，有人提出毛细血管床被颗粒性碎片微栓塞会导致多器官衰竭。6例暴发性肝衰竭患者接受了富含纤连蛋白的浓缩制剂大剂量注射。纤连蛋白给药后1小时，血浆免疫反应性纤连蛋白平均水平从最初的53±标准误12微克/毫升升至295±30微克/毫升（P＜0.001）。体外血浆调理活性在1小时时也从对照的5.6±3.6%升至102±13%（P＜0.005）。微聚集白蛋白清除率未观察到类似效应，但由于其清除率可能不依赖于纤连蛋白，这可能反映了网状内皮细胞功能的不同方面。心肺功能和氧利用未观察到显著变化，这可能是因为调理颗粒的清除受库普弗细胞损伤的限制。
