Wortel C H, von der Möhlen M A, van Deventer S J, Schipper H G, Lorijn R H, ten Cate J W
Afd. Hemostase, Trombose, Atherosclerose en Ontstekings Onderzoek, Academisch Medisch Centrum, Amsterdam.
Ned Tijdschr Geneeskd. 1993 Feb 13;137(7):350-4.
Passive immunization with a human anti-endotoxin monoclonal IgM antibody (Centoxin, HA-1A) was recently studied in patients with suspected Gram-negative sepsis. Comparison of the results obtained in the Amsterdam subpopulation with those in a larger international study population of which the Amsterdam patient group was a part, showed that it had been possible to select a patient population in which HA-1A has an 'intention-to-treat' effect based upon clinical criteria (a decrease in mortality compared with placebo by 42% (p = 0.04) and in the larger study by 9% (p = 0.24). Until a clinically useful test becomes available, identification of patients who have a high likelihood of Gram-negative sepsis and who would benefit from anti-endotoxin immunotherapy with HA-1A should be based upon the history and evaluation of underlying disease, infection status, severity and progression of the disease. The severely ill patients thus selected should receive treatment as early as possible.
最近对疑似革兰氏阴性菌败血症患者进行了用人抗内毒素单克隆IgM抗体（Centoxin，HA-1A）进行被动免疫的研究。将阿姆斯特丹亚组的结果与包含阿姆斯特丹患者组的更大国际研究人群的结果进行比较，结果表明，有可能根据临床标准选择出HA-1A具有“意向性治疗”效果的患者群体（与安慰剂相比死亡率降低42%（p = 0.04），在更大规模研究中降低9%（p = 0.24））。在有临床可用检测方法之前，识别革兰氏阴性菌败血症可能性高且能从HA-1A抗内毒素免疫治疗中获益的患者，应基于基础疾病史、感染状况、疾病严重程度和进展情况进行评估。如此选出的重症患者应尽早接受治疗。
