内毒素(G^-菌脂多糖)的连续监测与临床用药分析  

Continuous monitoring and clinical application of endotoxin(G^-lipopolysaccharides,LPS) in sepsis patients

作　　者：冯强生[1] 哈小琴[1] 宋月娟[1] 林静[1] 朱晓红[1] 李泽慧[1] 

机构地区：[1]中国人民解放军兰州军区兰州总医院检验科,甘肃兰州730050

出　　处：《中国卫生检验杂志》2014年第9期1295-1296,1299,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的研究重症脓毒血症患者血液中内毒素(G-菌脂多糖)的浓度与临床用药的关系。方法用MB-80微生物快速动态检测系统革兰阴性菌脂多糖检测试剂盒,检测17例重症脓毒血症患者血浆中的G-菌脂多糖含量>100 pg/ml的患者,并对其入院诊断、用药前后G-菌脂多糖值、微生物培养结果和临床抗生素使用进行分析。结果17例重症脓毒血症患者血液中G-菌脂多糖微生物培养结果为肠杆科菌,不动杆菌占多数;入院科室为ICU或急诊科重症脓毒血症患者;G-菌脂多糖浓度>100 pg/ml患者进行抗生素药物治疗,用药后G-菌脂多糖含浓度降低为较低水平或正常值,病人体症恢复正常,说明G-菌脂多糖浓度测量指导抗生素治疗具有明显的疗效。结论重症脓毒血症患者血液中G-菌脂多糖的连续检测用于重症脓毒血症患者感染的早期诊断,指导临床经验用药和抗生素的合理用药。Objective To study the relationship between concentration of G^-lipopolysaccharides（LPS） and clinical application of antibiotics in severe sepsis patients. Methods Gram negative bacterial lipopolysaharide detection reagents of MB- 80 Microbiology Kinetic rapid reader were used to detect the concentration of LPS in fever patients of unkonwn origin,then 17 severe sepsis patients with LPS above 100 pg / ml were involved to analyze the admitting diagnosis status,LPS contents before and after clinical medication,microbial culture results and clinical antibiotics use. Results The microbial culture results showed that the pathogen was enterobacteriaceae in 17 sepsis patients,and most were acinetobacter. These sepsis cases were mainly from ICU and emergency department. The LPS level in patients with LPS concentration above 100 pg / ml were found dropped to a low level or normal value after antibiotic therapy,indicating LPS level detection had obvious effect on antibiotic therapy. Conclusion Continuous G^-LPS detection as a rapid test can be used for early diagnosis of sepsis patients,of great significance in instructing empirical antibiotics treatment and rational use of drugs.

关 键 词：脓毒血症 内毒素 G^-菌脂多糖 检测 临床用药 

分 类 号：R446.11[医药卫生—诊断学]