Clinical experience on the detection of endotoxemia with the limulus test.
Clinical experience on the detection of endotoxemia with the limulus test.
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鲎试验检测内毒素血症的临床经验
DOI：
10.1093/infdis/127.1.102
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发表时间：
1973
期刊：
影响因子：
--
通讯作者：
R. Tilton
中科院分区：
文献类型：
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作者：
Luis A. Martinez;R. Quintiliani;R. Tilton
对 83 名疑似严重感染的住院患者进行了循环内毒素的研究；使用鲎裂解物测试。尽管该组中有 39 名患者感染了能够将内毒素释放到循环中的微生物，但只有两名患者检测结果呈阳性。由于在两个阳性病例中检测到内毒素之前必须重复多次测试，并且由于其中一名患者仅通过血培养就可以做出诊断，因此我们的结果对鲎试验作为诊断辅助手段的有效性产生了严重怀疑。尽管人们普遍认为内毒素是革兰氏阴性菌严重感染中观察到的许多异常变化的原因，但对此概念仍然存在一些疑问。而且，在因感染此类生物体而出现菌血症或循环衰竭的患者中，内毒素的发现并不统一。本研究的目的是提供有关鲎试验对疑似败血症患者的常规诊断价值的更多信息，并进一步阐明内毒素在人类感染中的作用。材料和方法
Eighty-three hospitalized patients suspected of having serious infections were studied for the presence of circulating endotoxin; the limulus lysate test was used. Although 39 patients in this group were infected with organisms capable of releasing endotoxin into the circulation, only two patients had a positive test. Since the test had to be repeated several times before endotoxin was detected in the two positive cases and since the diagnosis could have been established with blood cultures alone in one of these patients, our results cast serious doubt on the usefulness of the limulus test as a diagnostic aid. Although it is widely assumed that endotoxin is the cause of many of the abnormal changes observed in severe infections with gram-negative bacteria, there is still some doubt regarding this concept. Moreover, in patients with bacteremia or circulatory collapse due to infection with this type of organism, endotoxin is not found uniformly. This study was undertaken to provide additional information with respect to the routine diagnostic value of the limulus test in patients with suspected sepsis and to further clarify the role of endotoxin in human infections. Materials and Methods