Grundmann R, Ingenhoff E
Dtsch Med Wochenschr. 1986 Mar 21;111(12):457-62. doi: 10.1055/s-2008-1068474.
197 patients monitored postoperatively for more than two days in an intensive-care unit were followed up prospectively for nine months. Endotoxin plasma levels were determined daily by means of the limulus amoebocyte lysate test. In endotoxin-positive patients there was a statistically significantly higher incidence of peritonitis, sutural insufficiency, pneumonia, and sepsis. The diagnostic value of the test was found to be higher if the patients were considered "septic" only when endotoxin was positive for more than two days. In that case the specificity of the test was 80.6%; this was superior to that of a corresponding rise in leukocyte count or in body temperature. The positive predictive value for septic complications was 67.6%. Determination of the course of the endotoxin titre is more relevant than recording an isolated rise. This allows differentiation between septic and non-septic diseases.
对197例在重症监护病房术后监测超过两天的患者进行了为期九个月的前瞻性随访。每天通过鲎试剂试验测定血浆内毒素水平。在内毒素阳性患者中，腹膜炎、缝合口漏、肺炎和败血症的发生率在统计学上显著更高。如果仅当内毒素阳性超过两天时才将患者视为“脓毒症”，则该试验的诊断价值更高。在这种情况下，该试验的特异性为80.6%；这优于白细胞计数或体温相应升高的情况。脓毒症并发症的阳性预测值为67.6%。测定内毒素滴度的变化过程比记录单次升高更有意义。这有助于区分脓毒症和非脓毒症疾病。
