Yoshida M, Obayashi T, Tamura H, Tanaka S, Kawai T, Sakamoto S, Miura Y
Department of Medicine, Jichi Medical School, Tochigi, Japan.
Eur J Cancer. 1994;30A(2):145-7. doi: 10.1016/0959-8049(94)90074-4.
We evaluated the clinical utility of a new endotoxin-specific chromogenic limulus test in febrile patients with haematological malignancies. The specificity is assured by the removal of factor G, which is sensitive to (1-->3)-beta-D-glucan, from horseshoe crab amoebocyte lysate. The sensitivity and specificity of the test to systemic gram-negative bacterial infections were 69.7 and 96.3%, respectively. Meanwhile, gram-negative bacteria grew in only 39.7% of endotoxaemic samples. Thus, it seems appropriate to consider gram-negative bacteraemia and endotoxaemia as different entities. Endotoxaemia was significantly associated with septic shock and infectious death, especially in patients with neutropenia. The new test, the results of which are available within 3 h, should help physicians to recognise this ominous sign early and to initiate a prompt countermeasure to endotoxaemia.
我们评估了一种新型内毒素特异性显色鲎试剂检测法在血液系统恶性肿瘤发热患者中的临床应用价值。通过从鲎变形细胞裂解物中去除对（1→3）-β-D-葡聚糖敏感的G因子来确保检测的特异性。该检测法对全身性革兰氏阴性菌感染的敏感性和特异性分别为69.7%和96.3%。同时，仅39.7%的内毒素血症样本中培养出革兰氏阴性菌。因此，将革兰氏阴性菌血症和内毒素血症视为不同的实体似乎是合适的。内毒素血症与感染性休克和感染性死亡显著相关，尤其是在中性粒细胞减少的患者中。这种新检测法在3小时内即可得出结果，应有助于医生尽早识别这一不祥迹象，并对内毒素血症迅速采取应对措施。
