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目的：阐明鲎细胞溶解物试验（ＬＡＬ）检测支气管肺泡灌洗液（ＢＡＬＦ）在诊断革兰阴性杆菌肺炎中的作用。方法：ＬＡＬ测定采用半定量法。ＢＡＬＦ经纤维支气管镜导管法采集。结果：１０例经细菌学确诊患者ＢＡＬＦ内毒素水平均大于１∶１６。细菌学确定的革兰阴性菌肺炎与ＢＡＬＦ内毒素大于或等于１∶１６阳性之间总符合率为９０％（Ｋａｐｐａ系数０．６７）。经细菌学确诊的阴性菌肺炎组ＢＡＬＦ内毒素单位（ＥＵ）为１２．５×１０３ＥＵ／Ｌ，无肺炎组为１．８×１０３ＥＵ／Ｌ，差异有显著性（Ｐ＜０．０１）。结论：以ＬＡＬ检测ＢＡＬＦ为诊断阴性菌肺炎的一种快速、准确、简便的试验方法。
OBJECTIVE: To elucidate the role of bronchoalveolar lavage fluid (BALF) in the diagnosis of Gram-negative bacilli pneumonia by solute cell lysate assay (LAL). Methods: LAL assay was semi-quantitative. BALF was collected by fiberoptic bronchoscopy. Results: The bacterial endotoxin levels in 10 patients diagnosed by bacteriology were both higher than 1:16. The overall coincidence rate was 90% (Kappa coefficient 0.67) between bacteriologically determined Gram-negative bacteria pneumonia and BALF endotoxin greater than or equal to 1:16 positive. The BALF endotoxin unit (EU) was 12.5 × 103EU / L in BALB / c pneumonia group and 1.8 × 103EU / L in non-pneumonia group. The difference was significant (P <0.01). Conclusion: The rapid, accurate and simple test method for the detection of BALF by LAL is the diagnosis of pneumonia in the negative bacteria.