Fossard D P, Kakkar V V, Elsey P A
Br Med J. 1974 Jun 1;2(5917):465-8. doi: 10.1136/bmj.2.5917.465.
The occurrence of endotoxaemia in 46 surgical patients has been investigated using a sensitive preparation of limulus lysate. Altogether 23 patients with local and systemic Gram-negative infections were shown to have endotoxaemia. An overt infection is not a prerequisite for a positive limulus test result, since endotoxin can be absorbed via the peritoneal cavity in patients with "chemical" peritonitis. Over 70% of the tests performed during episodes of Gram-negative infection or peritonitis gave positive results. In 23 patients without clinical evidence of infection or peritonitis only 15% of the limulus test results were positive. The implications of these findings and the use of the test in clinical practice are discussed.
已使用一种敏感的鲎试剂制剂对46例外科手术患者的内毒素血症发生情况进行了调查。共有23例患有局部和全身性革兰氏阴性菌感染的患者被证明存在内毒素血症。明显的感染并非鲎试剂检测结果呈阳性的先决条件,因为在患有“化学性”腹膜炎的患者中,内毒素可通过腹腔被吸收。在革兰氏阴性菌感染或腹膜炎发作期间进行的检测中,超过70%的结果呈阳性。在23例无感染或腹膜炎临床证据的患者中,只有15%的鲎试剂检测结果呈阳性。讨论了这些发现的意义以及该检测在临床实践中的应用。