细菌内毒素检测方法及其临床应用

Bacterial endotoxin test and its clinical application

细菌内毒素可引起发热、微循环障碍、内毒素血症、脓毒性休克和弥散性血管内凝血等。鲎试验法是最常用的内毒素检测方法,其分为凝胶法和光度测定法,后者又可分为浊度法和显色基质法。内毒素检测对革兰阴性菌感染诊断具有重要的参考价值,也用于药品、医疗器械和环境的内毒素监测。内毒素检测对细菌感染诊断的敏感性与革兰阴性菌的种类有关,临床上可联用内毒素检测和其他检测手段如降钙素原检测来提高感染早期诊断的准确性。

Bacterial endotoxin can cause fever, microcirculatory disturbance, endotoxemia, septic shock and disseminated intravascular coagulation. Limulus amoebocyte lysate （LAL） assay is the main method for endotoxin detection, which can be divided into gel and photometric methods, and the latter includes turbidimetric method and chromogenic substrate method. LAL assay has an important reference value in the diagnosis of Gram-negative bacterial infection and can also be used for endotoxin test in drug, medical device and environment. The sensitivity of endotoxin test for the diagnosis of bacterial infection depends on the Gram-negative bacterial strains. Clinical endotoxin test can be used together with other tests such as procalcitonin to improve the accuracy of early diagnosis of infection.