ENDOTOXEMIA IN HUMAN SEPTIC SHOCK
ENDOTOXEMIA IN HUMAN SEPTIC SHOCK
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DOI：
10.1378/chest.99.1.169
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发表时间：
1991-01-01
期刊：
影响因子：
9.6
通讯作者：
PARILLO, JE
中科院分区：
文献类型：
--
作者：
DANNER, RL;ELIN, RJ;PARILLO, JE
为了评价感染性休克中内毒素血症的发生率、模式和临床意义，对休克患者进行了频繁、连续的内毒素测定。 100例感染性休克患者中有43例出现可检测到的内毒素，但10例非感染性休克患者中只有1例出现内毒素。 在感染性休克期间，内毒素血症经常在没有革兰氏阴性菌血症的情况下发生。 使用逻辑回归模型，内毒素血症患者多器官功能衰竭的发生率是正常人的10.3倍，左心室射血分数降低（小于或等于45%）的发生率是正常人的4.8倍。 在血培养阳性的患者中，内毒素血症与高死亡率相关。 我们的结论是，内毒素血症经常发生在感染性休克，并与严重的表现，这种综合征，包括心脏抑制和多器官功能衰竭。 这项研究表明，内毒素是感染性休克的重要介质，并支持努力开发抗内毒素治疗这种疾病的患者。
To evaluate the incidence, pattern and clinical importance of endotoxemia in septic shock, frequent, serial endotoxin determinations were made prospectively in patients with shock. Detectable endotoxin occurred in 43 of 100 patients with septic shock, but in only one of ten patients with shock due to nonseptic causes. During septic shock, endotoxemia frequently occurred in the absence of Gram-negative bacteremia. Using a logistic regression model, multiple organ failure occurred 10.3 times more frequently and depression of left ventricular ejection fraction (less-than-or-equal-to 45 percent) 4.8 times more frequently in endotoxemic patients. In patients with positive blood cultures, endotoxemia was associated with a high mortality. We conclude that endotoxemia occurs frequently in septic shock and is associated with severe manifestations of this syndrome, including cardiac depression and multiple organ failure. This study suggests that endotoxin is an important mediator of septic shock and supports efforts to develop anti-endotoxin therapies for treating patients with this disease.