肾移植后细菌败血症治疗过程中内毒素血症和菌血症的动态变化

为研究败血症时细菌溶解的程度对内毒素血症的影响,本文对肾移植术后怀疑为革兰氏阴性杆菌败血症患者的血中内毒素和细菌进行了定量检查。13名患者中有4人血中细菌定量>50cfu/ml,其血中内毒素水平由开始检查到最高峰时相差2～35倍,有一名患者在使用抗生素治疗过程中突然发生休克,最后由于呼吸、循环衰竭而死亡,其血中内毒素明显升高。本文结果表明:对于感染发病率很高的肾移植患者,如何控制和处理抗生素治疗后的高内毒素血症是一个值得研究的问题。血中内毒素和细菌的定量检查可以为及时采取针对性措施,防治内毒素血症提供依据。

Seria Quantitation of Endotoxemia and Bacteremia during Therapy for Gram-negative Bacterial Sepsis after Renal Transplantation

To study the degree of bacterial cell lysis and It'sinfluence to endotoxemia, we quantified levels ofplasma endotoxin and bacteremia serially in trans-plant patients suspected with sepsis. Four patients hadinitial levels of bacteremia characterizedby>50cfu/ml. Fold-change from initial to peak levelof endotoxin is 2-35. One patient was shock when an-tibiotic therapy began and died of pul-monary andcardiac failure. The endotoxin in the patient's bloodwas at high level. We concluded that; for the renaltransplant patients, how to control the endotoxemiais a problem that needs to be studied. Quantitation ofendotoxemia and bacteremia can give the data forcontrolling endotoxemia.