Lanser M E, Saba T M, Scovill W A
Ann Surg. 1980 Dec;192(6):776-82. doi: 10.1097/00000658-198012000-00014.
The time course of immunoreactive and bioassayable opsonic alpha 2-SB glycoprotein (plasma fibronectin), as well as its relationship to both the extent of injury and development of postburn sepsis, was evaluated following burn injury. Immunoreactive opsonic fibronectin was depleted acutely within hours following burn; its maximal depletion occurring 12 hours postburn injury. The magnitude of depletion was correlated with the body surface area burned, and normal levels were restored at 24 hours postinjury. There was a tendency toward rebound hyperopsonemia at two weeks postburn, with a slow return to normal over the ensuing weeks. Bioassayable opsonic protein levels, in general, paralleled those of immunoreactive protein. Following restoration of opsonic protein levels, a secondary phase of opsonic fibronectin deficiency (p equal to 0.05) developed in those burn patients that became septic. Moreover, this opsonic fibronectin deficiency actually became apparent prior to the onset of clinical sepsis, although it was maximal during sepsis. The resolution of the septic episode was associated with the return of plasma opsonic fibronectin levels to normal. The possibility that secondary deficiency in immunoreactive opsonic fibronectin may be a reliable index of impending sepsis following burn warrants further investigation.
在烧伤后，对免疫反应性和生物活性调理素α2-SB糖蛋白（血浆纤连蛋白）的时间进程及其与损伤程度和烧伤后脓毒症发展的关系进行了评估。免疫反应性调理素纤连蛋白在烧伤后数小时内迅速减少；其最大减少量发生在烧伤后12小时。减少的幅度与烧伤的体表面积相关，损伤后24小时恢复到正常水平。烧伤后两周有超调理素血症反弹的趋势，在随后几周缓慢恢复正常。一般来说，生物活性调理素蛋白水平与免疫反应性蛋白水平平行。在调理素蛋白水平恢复后，发生脓毒症的烧伤患者出现了调理素纤连蛋白缺乏的第二阶段（p = 0.05）。此外，这种调理素纤连蛋白缺乏在临床脓毒症发作之前就已明显，尽管在脓毒症期间最为严重。脓毒症发作的缓解与血浆调理素纤连蛋白水平恢复正常有关。免疫反应性调理素纤连蛋白继发性缺乏可能是烧伤后即将发生脓毒症的可靠指标，这一可能性值得进一步研究。
