[Clinical significance of detection of plasma fibronectin in respiratory failure].

Plasma fibronectin (PFn) level was measured with immumoelectrophoresis in 40 healthy adults and 174 patients (221 person-times) with respiratory insufficiency (R I). The levels of PFn in 40 healthy adults, 85 person-times of R I, 27 person-times of Type I respiratory failure (RF I), 82 person-times of RF II, and 27 person-times of iatrogenic RF (IRF) were 292.48 +/- 43.11 mg/L, 253.12 +/- 67.00 mg/L 141.97 +/- 70.84 mg/L, 180.48 +/- 49.96 mg/L and 263.49 +/- 70.05 mg/L respectively. The levels of PFn of patients with R I, RF I and RF II were significantly lower than that in healthy adults (P < 0.001). The level of PFn of patients with TRF was significantly lower than that in healthy adults (P < 0.05). There was positive correlation between the levels of PFn and PaO2 in 221 person-times of R I (r = 0.5358, P < 0.001), RF I r = 0.3822, P < 0.05). RF II (r = 0.3050, P < 0.01), and IRF (r = 0.4963, P < 0.02). There was negative correlation between the levels of PFn and PaCO2 in 221 person-times of R I (r = -0.2053, P < 0.005) and RF II (r = -0.2181, P < 0.05). In 34 patients with RF, the PFn before treatment was significantly lower than that two weeks after treatment (147.80 +/0 61.59 mg/L vs 214.56 +/- 56.12 mg/L) (P < 0.001). Among 33 cases of RF whose level of PFn was < 150 mg/L, 18 cases complicated multiple system organ failure and 4 cases complicated adult respiratory distress syndrome. The average level of PFn in 3 death cases was lower than 100 mg/L. It is suggested that PFn level might be used as an index in making early diagnosis, monitoring RF and predicating progosis of RF.