【摘要】目的符合透析治疗安全的透析用水是血液透析日常治疗开展的基本保障，根据统计分析内毒素含量的变化规律,探索控制透析用水内毒素含量的管理方式。方法对上海市21 家血液净化中心(室)2019 年3 月至2020 年2 月期间透析用水的内毒素(endotoxin, ET)含量数据进行汇总与统计分析。结果透析用水内毒素含量在全年的春季与夏季中会存在部分偏高的情况，其中春季送检的样本中，ET含量＞0.25 EU/ml 比例占当季送检样本的0.57%，ET 含量在0.03～0.25EU/ml 之间的比例占7.34%；在夏季送检的样本中，ET 含量＞0.25EU/ml 比例占当季送检样本的1.13%，ET 含量在0.03～0.25EU/ml 之间的比例占3.39%，与秋冬两季水平相比，差异有统计学意义(F=11.392，P 值＜0.001)。结论严格管控透析用水生产、输送过程的每个环节，规范采样流程、加强反渗机日常维护管理、重视水处理系统及配管的日常消毒等措施可减少血液透析相关的不良反应发生，提高患者透析质量。

【Abstract】Objective Dialysis water compliant with the safety standards is fundamental to the daily work in hemodialysis centers. This study aimed to explore the management methods to limit the endotoxin content in dialysis water using the changes of endotoxin content data from hemodialysis centers as the reference. Method The data of endotoxin content in dialysis water from March 2019 to February 2020 in 21 blood purification centers in Shanghai were recruited and analyzed. Result Endotoxin content in dialysis water increased in the spring and summer in a part of the samples. Endotoxin content >0.25 EU/ml accounted for 0.57% and endotoxin content of 0.03～0.25 EU/ml accounted for 7.34% in the water samples detected in the spring, while endotoxin content >0.25 EU/ml accounted for 1.13% and endotoxin content of 0.03～0.25 EU/ml accounted for 3.39% in the water samples detected in the summer. The difference of endotoxin content was statistically significant between the water samples detected in the summer and those detected in the winter (F=11.392, P=0.001). Conclusion To reduce the adverse reactions relating to hemodialysis and to promoting the hemodialysis quality, care must be focused on rigorous control of every steps in production and transportation of dialysis water, standardized processes of sampling, daily maintenance and management of the reverse osmosis machines, and thorough disinfection of the water treatment and pipe system.