尿液内毒素定量检测对泌尿系统革兰阴性菌感染的诊断价值研究

Significance of quantitative detection of urinary endotoxin for the diagnosis of gram-negative bacteria infection in urinary system

目的评估尿液内毒素定量检测对泌尿系统革兰阴性菌感染的诊断意义。方法采用鲎试剂动态浊度法对100份来自不同病区的尿液标本进行内毒素浓度检测,并同时进行尿液细菌培养检测。分析内毒素水平与泌尿系统革兰阴性菌感染的关系。结果尿液细菌培养检出革兰阴性菌阳性标本18份,其内毒素水平显著高于检出革兰阳性菌、真菌及培养阴性的尿液标本(P<0.05)。统计学分析显示,尿液内毒素检测结果与尿液细菌培养检测结果的一致性较好,前者对革兰阴性菌感染的诊断灵敏度为88.9%、特异度为85.4%。随着泌尿系统革兰阴性菌感染患者经治疗后症状好转,尿液内毒素水平亦显著降低(P<0.05)。结论尿液内毒素定量检测对泌尿系统革兰阴性菌感染的诊断及患者疗效评价方面有重要意义。

Objective To assess the diagnostic value of quantitative detection of urinary endotoxin for the di-agnosis of gram-negative bacteria infection in urinary system.Methods The levels of urinary endotoxin were detec-ted in 100 urine specimens from different wards by using kinetic turbidimetric technique with limulus reagent.At the same time,urine culture detection was processed.The relationship of endotoxin and gram-negative bacteria infections in urinary system was analyzed.Results By culture detection,1 8 urine specimens with gram-negative bacteria were confirmed,in which,the levels of endotoxin were significantly higher than those without gram-negative bacteria （P＆lt;0.05）.It was shown that the levels of endotoxin were consistent with the results of urine culture.The diagnostic sensitivity and specificity of urinary endotoxin for gram-negative bacteria infection in urinary system were 88.9% and 85.4%.Levels of urinary endotoxin were significantly reduced in patients receiving anti-infectious therapy（P＆lt;0.05）.Conclusion Detection of urine endotoxin could be used for the diagnosis of gram-negative bacteria infection in urinary system and the evaluation of therapeutic effect.