Ishizaki M, Oikawa K, Miyashita E
Kidney Center, Eijinkai Nagano Hospital, Miyagi, Japan.
Adv Perit Dial. 1996;12:199-202.
The endotoxin (ET) in cloudy peritoneal fluid was measured, and the usefulness of the method was examined. Thirteen continuous ambulatory peritoneal dialysis (CAPD) patients with an episode of peritonitis from December, 1993 to December, 1995 were studied. The peritoneal fluid was collected without contamination from the bags and divided into two batches. The ET was measured in one of them with the limulus amebocyte lysate (LAL) assay, and the other was cultured for bacteria. Among the 13 patients ET was positive in 7 Gram-negative bacteria were identified in all 7 cases. Two of these patients were transferred to hemodialysis. On the other hand, gram-positive bacteria were cultured in only four episodes of the 6 ET-negative patients, all of which were treated successfully with vancomycin. Microbiological culture of the dialysate is still necessary for the treatment of peritonitis. But it takes 24-48 hours to obtain microbiological results. The result of the ET test can be given within one and one half hours (and it has 100% sensitivity and specificity for gram-negative peritonitis) at presentation in the episodes. Therefore, the ET test of the dialysate is very effective for the therapy of peritonitis in CAPD.
对浑浊的腹膜透析液中的内毒素（ET）进行了检测，并对该方法的实用性进行了研究。研究对象为1993年12月至1995年12月期间发生腹膜炎的13例持续性非卧床腹膜透析（CAPD）患者。从袋子中无污染地收集腹膜透析液并分成两批。其中一批用鲎试剂法检测ET，另一批进行细菌培养。13例患者中，7例ET呈阳性，所有7例均鉴定出革兰氏阴性菌。其中2例患者转为血液透析。另一方面，6例ET阴性患者中仅有4次培养出革兰氏阳性菌，所有这些患者均用万古霉素成功治疗。透析液的微生物培养对于腹膜炎的治疗仍然是必要的。但获得微生物学结果需要24至48小时。ET检测结果可在发病时1个半小时内得出（对革兰氏阴性腹膜炎的敏感性和特异性均为100%）。因此，透析液的ET检测对CAPD患者腹膜炎的治疗非常有效。
