小児外科疾患における主要血漿蛋白質の測定とその臨床的意義

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Little is known about the significance of plasma proteins in various pediatric surgical conditions. Seventeen different varieties of plasma proteins were studied using single radial immunodiffusion method in patients with malnutrition, obstructive jaundice, and malignant tumors. Normal ranges for each age were determined by the measurement of otherwise healthy infants and children with inguinal hernia. The following results were obtained 1. The decrease of rapid turnover proteins was more remarkable in acute malnutrition (hypertrophic pyloric stenosis) than in chronic malnutrition (patients with ileostomy). 2. It was impossible to differentiate congenital biliary atresia from neonatal hepatitis before operation by means of the measurement of plasma proteins. Prealbumin, Albumin, β_2-Glycoprotein I, IgG, IgA, IgM showed significant changes in congenital biliary atresia with liver cirrhosis. It suggests that the severity of liver cirrhosis in congenital biliary atresia could be diagnosed by these plasma proteins. 3. Six to ten days after radical operation, Prealbumin, α_2-Macroglobulin significantly decreased, while α_1-Acid Glycoprotein, IgA, and IgM significantly increased. Acute phase response to surgical trauma was influenced by impaired hepatic function in the patients with obstructive jaundice. Hepatic function should be taken into account to diagnose postoperative complications by measurement of acute phase proteins. 4. Prealbumin and IgG showed significant decrease in infants with malignant tumors, while acute phase proteins (α_1-Antitrypsin, Haptoglobin, and Ceruloplasmin) had a tendency to increase. Serial measurements of these plasma proteins could be a useful diagnostic tool for detecting relapse or recurrence of malignant tumors.
日本小児外科学会の論文
1987-10-20

小児外科疾患における主要血漿蛋白質の測定とその臨床的意義

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