唐山地区真菌性角膜炎的病原学分析及诊断  

Pathogenic analysis and diagnosis of dungal keratitis inTangshan Region

作　　者：刘素媛[1] 张岸平[2] 单秀水[3] 岳丽[4] 

机构地区：[1]唐山市眼科医院检验科,河北唐山063000 [2]河北联合大学生命科学院 [3]唐山市眼科医院 [4]唐山市眼科医院医教科

出　　处：《中国实用眼科杂志》2013年第7期884-886,共3页Chinese Journal of Practical Ophthalmology

基　　金：唐山市科技局资助（08150201A-1）

摘　　要：目的对真菌性角膜炎的病原菌变化及实验室诊断进行总结，为该病的诊断治疗提供可靠的依据。方法分析2008～2012年5年间在唐山市眼科医院拟诊为真菌性角膜炎的病例530份，统计其涂片Giemsa染色细胞学检查及真菌培养阳性率，应用卡方检验和百分比统计方法，将这些资料与1999～2003年的材料进行比较，并分析其发病的季节性分布规律。结果在530份标本中涂片Giemsa染色细胞学检查发现真菌菌丝233例，阳性率43．97％，真菌培养阳性296例，阳性率55．84％。且发病季节多集中于9—12月份，占60．6％。2008—2012年镰孢菌属、无孢菌属，曲霉菌属，链格孢菌属分别是前四位的致病菌属，各占：67．24％，19．26％，7．43％和5．07％。结论近十年就诊的真菌性角膜炎患者呈增加趋势；涂片染色法是快速诊断可疑真菌性角膜炎的首选方法；镰孢菌属是我地区真菌性角膜炎的主要致病菌属，占67．24％；无孢菌属和曲霉菌属呈上升趋势，链格孢菌属呈下降趋势。Objective To analyze the macroscopical shifting trends and laboratory diagnosis of pathogenic bacteria in fungal keratitis, to provide a dependable basis for the diagnosis and treatment of the disease. Methods This study retrospectively reviewed 530 cases that diagnosed as fungal kera- titis in Tangshan ophthalmic hospital between 2008 and 2012, and statistic analyzed their smear Giem- sa stain cytology, ftmgal culture. These data was compared by using chi-square test and percentages, and compared those with data in the period of 1999-2003. Its seasonal distribution of the disease was analyzed. Results Of 233 cases of fimgal hyphae from the 530 samples were revealed, through Giemsa stained smear cytology examination, and the positive rate was 43.97%, and 296 cases of fun- gal culture was positive, the positive rate 55.84%. And the season of incidence focused on the 9-12 month, accounted for 60.6%. In 2008-2012 Fusarium species, No-spore species, Aspergillus, Alternaria species were the top four pathogens, respectively, accounted for 67.24%, 19.26%, 7.43% and 5.07% respectively. Conclusions Fungal keratitis cases need treatment in our hospital is increasing in re- cent 10 years. Smear staining method is a rapid diagnosis method of suspected fungal keratitis. Fusar- ium species is the major fungal pathogens in our area, accounting for 67.24% and is always the first pathogen. Aspergillus species and no-spore species are uptrend, however Altemaria species decline.

关 键 词：真菌性角膜炎 培养 GIEMSA染色 

分 类 号：R772.21[医药卫生—眼科]