ENDOTOXEMIA IN PATIENTS WITH LIVER-CIRRHOSIS AND UPPER GASTROINTESTINAL-BLEEDING - DETECTION BY THE CHROMOGENIC ASSAY WITH PLASMA TWEEN-80 PRETREATMENT
ENDOTOXEMIA IN PATIENTS WITH LIVER-CIRRHOSIS AND UPPER GASTROINTESTINAL-BLEEDING - DETECTION BY THE CHROMOGENIC ASSAY WITH PLASMA TWEEN-80 PRETREATMENT
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DOI：
10.1111/j.1440-1746.1993.tb01656.x
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发表时间：
1993-11-01
影响因子：
4.1
通讯作者：
TSUJII, T
中科院分区：
文献类型：
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作者：
FUKUI, H;MATSUMOTO, M;TSUJII, T
采用血浆Tween 80前处理的显色内毒素检测法与传统的稀释和加热法进行了比较。用这些方法测定了肝硬化和上消化道出血患者的血浆内毒素。通过在每个样品中加入三种不同的标准内毒素溶液，从单个内标曲线计算血浆内毒素浓度。采用常规加热法，添加的标准内毒素在每个样品中得到不同的OD值，标准曲线的斜率呈现个体间变化。慢性酗酒者血浆样品经1%吐温80预处理，加热后经超声处理，标准曲线斜率有所增加，个体间差异最小。采用Tween 80方法检测肝硬化合并上消化道出血患者的血浆内毒素水平明显高于无上消化道出血患者。在上消化道出血患者中，本法测定的内毒素水平与高氯酸法测定的内毒素水平和内毒素特异性底物之间存在强正相关。内毒素水平在出血后1-2天升高，随着患者康复而降低。综上所述，在显色底物测定前添加Tween 80可提高血浆样品中内源性和外源性内毒素的回收率。用Tween 80方法检测肝硬化和上消化道出血患者血浆内毒素的短暂升高。
A recently developed chromogenic endotoxin assay with plasma Tween 80 pretreatment was compared with the conventional dilution and heating method. Plasma endotoxin was measured in patients with liver cirrhosis and upper gastrointestinal (GI) bleeding by these methods. Plasma endotoxin concentration was calculated from an individual internal standard curve by adding three different standard endotoxin solutions to each sample. By the conventional heating method, added standard endotoxin gave different OD values in each sample and the slope of the standard curve showed interindividual variations. When sample plasma from chronic alcoholics was pretreated with 1% Tween 80 and ultrasonification after heating, the slope of standard curves was somewhat increased and interindividual variation was minimized. Significantly higher plasma endotoxin levels in cirrhotics with upper GI bleeding compared with those without upper GI bleeding was detected by this Tween 80 method. There was a strongly positive correlation between the endotoxin levels determined by this method and those determined by the perchloric acid method and endotoxin-specific substrate in patients with upper GI bleeding. Endotoxin levels, which were elevated 1-2 days after the bleeding, tended to decrease as patients recovered.In summary, the recovery of endogenous and exogenous endotoxin from plasma sample was increased by adding Tween 80 before the chromogenic substrate assay. Transient elevation of plasma endotoxin was demonstrated by this Tween 80 method in patients with liver cirrhosis and upper GI bleeding.