張幸真

摘 要 台灣地區五至十四歲成長發育中的兒童，每年約有千餘人死於意外事故或重大疾病，在事故或疾病發生之初，除了緊急的醫療救護外，適時、適當的營養支持介入將可減少住院的時間、避免醫藥的浪費及降低死亡率。 針對台中市公私立國民中學一年級、國民小學三年級及幼稚園大班兒童，以抽取率與單位大小成比例的多階段抽樣 (SSP) 方法抽出每個年齡層兒童各100人(男女各50人)，以酵素免疫接合吸附法 (ELISA) 分析該發育兒童血清中微量蛋白質 (rapid turnover protein；RTP )， 包括前白蛋白 (prealbumin)、 運鐵蛋白 (transferrin)、視網醇結合蛋白 (retinol-binding protein)、纖維網狀蛋白 (fibronectin)。分析結果：前白蛋白含量國中一年級兒童為43.59±11.12mg/dl、 國小三年級兒童為 40.37±10.53mg/dl、 幼稚園大班兒童為 18.33±9.42mg/dl ； 運鐵蛋白含量分別為219.15±92.45mg/dl, 214.3±68.15mg/dl, 197.05±72.6mg/dl； 視網醇結合蛋白含量分別為21.93±9.2mg/dl, 24.06±13.43mg/dl, 18.39±8.95mg/dl;纖維網狀蛋白含量分別為117.20±31.06mg/dl, 106.48±68.97mg/dl, 33.37±3.29mg/dl。 以 ELISA 法檢測血清中RTP含量，是一種既經濟又快速 的短期內營養評估方法，而本國目前並無前述各種RTP之本土 性資料，本研究結果應可作為一發育中健康兒童的基礎 data， 供共同之參考並利往後之追蹤及研究。未來對住院病童之 RTP 含量上，應進一步加以探討。 關鍵字：營養評估，微量蛋白質，酵素接合免疫吸附分析法， 前白蛋白，運鐵蛋白，視網醇結合蛋白，纖維網狀蛋白

Abstract There are thousand of children among 5~14 years died of accidents or severe diseases each year in Taiwan area . Protein energy malnutrition(PEM) is a common problem in hospitalized children. Early nutritional assessment can help identifying these children for whom nutritional supports are needed. Rapid turnover protein (RTP) which synthesized in the liver and has a much shorter half-life is indicated a sensitive, useful index for judging acute nutritional status of PEM. The purpose of this study was to evaluate serum RTP in the growing children. Prealbumin(PAB), transferrin(TF), retinol binding protein(RBP) and fibronectin(FN) were examined by enzyme-linked immunosorbent assay(ELISA). There were 300 healthy children (150 males and 150 females) with different ages involved in this study. The mean serum RTP values were： PAB, 43.59mg/dl in 1st grade middle-school children, 40.37mg/dl in 3rd grade primary-school children and 18.33mg/dl in preschool children； TF, 219.15mg/dl, 214.3mg/dl,197.05mg/dl； RBP, 21.93mg/dl, 24.06mg/dl, 18.39mg/dl； FN, 117.2mg/dl, 106.48mg/dl and 33.37mg/dl respectively. ELISA method is an useful and economical method for determining serum RTP levels in acute nutritional status. There is none of native RTP values in Taiwan area. We suggest that the results of this study to be used as basic data of healthy growing children. Further studies are needed to better evaluate RTP levels in hospitalized children. Key words: nutritional assessment, rapid turnover protein, enzyme-linked immunosorbent assay, prealbumin, transferrin, retinol binding protein, fibronectin