Urbaschek R, Becker K P
Institut für medizinische Mikrobiologie und Hygiene, Klinikum Mannheim, BRD.
Infusionsther Transfusionsmed. 1993 Apr;20 Suppl 1:16-9; discussion 20.
A number of problems may be involved in the detection of endotoxin in plasma of patients using LAL (Limulus amebocyte lysate). When collecting blood or processing samples, contamination with endotoxin or its adsorption to material must be avoided. In our laboratory a kinetic LAL microtiter assay was developed that takes into account plasma-related interferences with the LAL endotoxin reaction by performing an internal standardization in each sample. Negative results do not absolutely exclude the involvement of endotoxins in the underlying disease. High levels of endotoxins do not necessarily reflect the severeness of the clinical status of the patient. Due to nonendotoxin-specific reactions with some complete lysates, false-positive levels may result, e.g., following immunoglobulin therapy. In spite of these limitations, the LAL test remains a valuable tool in the evaluation of gram-negative infections.
使用鲎试剂（鲎血细胞溶解物）检测患者血浆中的内毒素可能涉及多个问题。采集血液或处理样本时，必须避免内毒素污染或其吸附到材料上。在我们实验室，开发了一种动态鲎试剂微量滴定法，通过在每个样本中进行内部标准化来考虑血浆对鲎试剂内毒素反应的相关干扰。阴性结果并不能绝对排除内毒素参与潜在疾病的可能性。内毒素水平高并不一定反映患者临床状况的严重程度。由于某些完全溶解物存在非内毒素特异性反应，可能会导致假阳性结果，例如在免疫球蛋白治疗后。尽管有这些局限性，鲎试剂检测仍然是评估革兰氏阴性菌感染的一种有价值的工具。
