Harris N S, Feinstein R
J Trauma. 1977 Sep;17(9):714-8. doi: 10.1097/00005373-197709000-00008.
The limulus amebocyte lysate (LAL) assay has proven to be a highly sensitive and reliable indicator of endotoxin in most biological fluids; however, it has not been a reliable indicator when used with blood because of different inhibitors present in the blood. To avoid these problems, investigators have used difficult extraction procedures, but but even with these, results were oftentimes not uniform. It was found that a recently developed inert polymer (PSI-HAP 100) has a specific affinity for endotoxin, so that is was possible to develop a simple, reliable, reproducible method for the detection of endotoxin in blood. In the assay procedure, the polymer, compressed into a 3-mm diameter bead, is incubated with 0.2 cc of heparinized whole blood. The bead is then removed from the blood, washed in pyrogen-free saline to remove any inhibitors of the LAL, and placed in a tube containing LAL. The LAL and bead are incubated together; after incubation the LAL is examined for gellation. Using this new method, it was possible to predict Gram-negative septic episodes in burn patients several days before sepsis evolved clinically.
鲎试剂（LAL）检测已被证明是大多数生物体液中内毒素的高灵敏度和可靠指标；然而，由于血液中存在不同的抑制剂，当用于血液检测时，它并不是一个可靠的指标。为了避免这些问题，研究人员采用了复杂的提取程序，但即便如此，结果往往也不一致。人们发现，一种新开发的惰性聚合物（PSI-HAP 100）对内毒素具有特异性亲和力，因此有可能开发出一种简单、可靠、可重复的血液内毒素检测方法。在检测过程中，将压缩成3毫米直径珠子的聚合物与0.2毫升肝素化全血一起孵育。然后从血液中取出珠子，用无热原盐水洗涤以去除LAL的任何抑制剂，并放入含有LAL的试管中。将LAL和珠子一起孵育；孵育后检查LAL是否发生凝胶化。使用这种新方法，可以在烧伤患者临床发生败血症前几天预测革兰氏阴性败血症发作。
