Goto T, Makinose S, Ohi Y
Department of Urology, Faculty of Medicine, Kagoshima University, Japan.
Int J Urol. 1995 Sep;2(4):238-42. doi: 10.1111/j.1442-2042.1995.tb00464.x.
Although endotoxin elicits a variety of pathophysiological activities in hosts with gram-negative bacterial infections, the clinical significance of plasma endotoxin levels have not been clearly defined in the patients with urinary tract infections. The purpose of the study was to measure plasma endotoxin concentrations in relation to the types of urinary tract infections and to examine their correlation with inflammatory parameters.
Using chromogenic Limulus-amebocyte lysate assay, plasma endotoxin concentrations were measured in a total of 63 patients with various types of nonspecific urinary tract infections.
The mean plasma endotoxin concentrations in patients with sterile pyuria, chronic complicated cystitis, acute uncomplicated pyelonephritis or acute exacerbation of chronic complicated pyelonephritis, chronic complicated pyelonephritis, and acute bacterial prostatitis or epididymitis were significantly higher than those in healthy individuals and in patients with acute uncomplicated cystitis. The correlation coefficients between plasma endotoxin concentrations and body temperatures, white blood cell counts in peripheral blood, erythrocyte sedimentation rates, and C-reactive proteins were 0.678 (P < 0.01), 0.503 (P < 0.01), and 0.330 (P < 0.01), respectively.
Patients with urinary tract infections may respond to endotoxin locally and generally depending on the sites of infection involved. However, endotoxin levels do not always correlate to clinical findings or inflammatory parameters.
尽管内毒素在革兰氏阴性菌感染宿主中引发多种病理生理活动，但尿路感染患者血浆内毒素水平的临床意义尚未明确界定。本研究的目的是测量与尿路感染类型相关的血浆内毒素浓度，并检查它们与炎症参数的相关性。
使用显色鲎试剂法，对总共63例患有各种类型非特异性尿路感染的患者测量血浆内毒素浓度。
无菌性脓尿、慢性复杂性膀胱炎、急性非复杂性肾盂肾炎或慢性复杂性肾盂肾炎急性加重、慢性复杂性肾盂肾炎以及急性细菌性前列腺炎或附睾炎患者的平均血浆内毒素浓度显著高于健康个体和急性非复杂性膀胱炎患者。血浆内毒素浓度与体温、外周血白细胞计数、红细胞沉降率和C反应蛋白之间的相关系数分别为0.678（P < 0.01）、0.503（P < 0.01）和0.330（P < 0.01）。
尿路感染患者可能根据感染部位对内毒素产生局部和全身反应。然而，内毒素水平并不总是与临床发现或炎症参数相关。
