[摘要] 目的：了解上海市血液透析用水和透析液中的内毒素（ET）污染现状及其相关因素。方法：以上海市36家医院的血液透析中心为调查对象，对各中心在2010年11月～2012年10月期间所送检的透析用水和透析液标本的ET检测结果予以分析。结果：① 2010年11月～2012年10月期间36家透析中心共送检标本4438份；其中3790份标本（85.40%）的ET含量＜0.1EU/ml，482份标本（10.86%）的ET水平在0.1～0.5EU/ml之间，其余166份标本（3.74%）的ET含量＞0.5EU/ml。② 透析中心水处理系统使用双级反渗的有14家，单级反渗的有22家；2042份单极反渗水处理系统的送检标本中，76.93%的ET含量＜0.1EU/ml，15.48%的ET水平在0.1～0.5EU/ml之间，前者低于双极反渗水处理系统的比例（90.32%），后者则高于双极反渗水处理系统的比例（6.93%），两者间的差异均有统计学意义。③ 对不同采集月份送检标本的内毒素含量进行比较的结果显示，8月份的ET含量与全年相比，差异有统计学意义。结论：上海地区血液透析中心的透析用水和透析液的内毒素控制情况总体满意。水处理设备及季节因素对内毒素水平有一定影响。

【Abstract】 Objective To investigate endotoxin (ET) in hemdialysis water and dialysate used in the hemodialysis centers in Shanghai, and the factors relating to the ET contamination. Methods Specimens of hemdialysis water and dialysate were collected from 36 hemodialysis centers in Shanghai during Nov. 2010 to Oct. 2012. ET contamination in hemdialysis water and dialysate were evaluated. Results (a) Of the 4438 samples obtained, 3790 (85.40%) contained ET＜0.1 EU/ml, 482 (10.86%) samples contained ET 0.1-0.5 EU/ml, and 166 (3.75%) contained ET＞0.5EU/ml. (b) In the 36 hemodialysis centers, 14 centers used double osmosis water treatment system and 22 centers used single osmosis water treatment system. In water samples from single osmosis system and double osmosis system, ET <0.1 EU/ml was found in 76.93% and 90.32% samples, respectively, and ET 0.1-0.5 EU/ml was detected in 15.48% and 6.93% samples, respectively. These differences were statistically significant. (c) The average ET level was significantly higher in August than in other months of the year. Conclusion The quality of hemdialysis water and dialysate was consistent with the national standards in most hemodialysis centers in Shanghai. Double osmosis system is better than single osmosis systems in treatment of water for hemodialysis. Seasonal influence also determined ET contamination in hemodialysis water.