血浆内毒素定量测定及其对呼吸科30例发热待查患者早期诊断意义初探

Study on the quantative detection of plasma endotoxin and the value of primary diagnosis for patients with unknown fever in the respiratory wards

目的 :建立血浆内毒素的动态浊度检测法并初步研究其在呼吸科发热待查实验诊断中的意义。方法 :评价动态浊度法的线性范围、准确度和精密度;检测100例健康人和30名呼吸科发热待查患者血浆中内毒素水平 ,并与细菌培养结果 (金标准 )进行对比。结果 :内毒素高 (5Eu/ml)、中 (2.5Eu/ml)、低(0.5Eu/ml)3种浓度的回收率分别为104.05 %、94.83 %、92.04 %。批内重复性CV=5.1 %、批间重复性CV=6.1 %、日间重复性CV=10.6 %;本室参考值范围为0.03～0.098Eu/ml[(0.064±2)×0.017Eu/ml,95%可信区间)]。测定呼吸科30名发热待查患者血浆内毒素水平时发现 ,细菌培养为G -菌患者的血浆内毒素水平明显高于培养为G+ 菌感染者和健康人 (P<0.001) ,细菌培养阴性患者的内毒素水平亦明显高于健康人 (P<0.05) ,4例G -菌感染者治疗前的内毒素水平明显高于治疗后 (P<0.001)。结论 :本方法的精密度和准确度都符合临床应用的要求 ,而且其线性范围较大(0.01～10Eu/ml) ,适用于临床应用 ;血浆内毒素检测有助于肺部G -菌感染的早期实验诊断,此外 。

Objective:To establish a kinetic turbidimetric method for the detection of plasma endotoxin and study its value of primary diagnosis for patients with unknown fever in the resˉpiratory wards.Methods:Using BET-16bacterium endotoxin detecter to evaluate the accuˉrancy precision and linear range of kinetic turbidimetric method and to determine the plasma endotoxin of100healthy person and30patients with unknown fever in the wards of respiratory medicine.The endotoxin level of the30patients was compared with their bacterial culture reˉsults.Results:The recoveries of endotoxin at different levels were104.05,94.83%,92.04%,respectively.The CV values for within-run,between-run and day to day assay were5.1%,6.1%,10.6%,respectively.The reference range of our laboratory was0.03-0.098Eu/ml.Endotoxin level of those patients whose culture results were G - bacterium was significantly over that of the others(P<0.001).Endotoxin levels of those patients whose culture results were negative were also over that of healthy persons(P<0.05).Conclusion:This method meets to the request of clinical application,and it can be used in early diagnosis of G-bacterial inˉfections.Besides,it also has great values in the laboratory diagnosis of patients with unknown fever whose bacterial culture results are negative.