老年人感染性角膜炎病因及病原学特征分析  

Epidemiological and etiological characteristics of infectious keratitis in the elderly

作　　者：孔令宇[1] 肖凤枝 郑素惠[1] 姜皓[1] 赵爱华[1] 王彩云[1] 刘素媛[1] 张小利[1] 

机构地区：[1]唐山市眼科医院角膜病病区,河北省063000

出　　处：《中国实用眼科杂志》2015年第9期1063-1066,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 分析老年人感染性角膜炎的病因、病原学特征.方法 对唐山市眼科医院于2013年1月至2014年12月确诊为感染性角膜炎的668例（671只眼）,60岁以上住院患者进行回顾性研究,对其病因及病原学特征进行分析.结果 老年人感染性角膜炎人数多,占角膜病49.5％（668/1350）,院前未规律治疗402例（60.2％ 402/668）,发病7d内入院148例（22.1％ 148/668）,病灶直径5 mm以上者154例（33.0％ 154/668）.细菌感染伴慢性泪囊炎或病毒性角膜炎者81例（71.7％ 81/113）,真菌感染合并病毒性角膜炎者31例（21.2％ 31/146）.老年人单纯病毒性角膜炎以复发病例为主277例（280只眼）（67.7％ 277/409）.65例（9.7％ 65/668）经药物治疗无效或好转但不能痊愈病例行手术治疗.培养致病菌真菌26例,其中镰刀霉菌13例（50％ 13/26）;细菌16例,其中唾液链球菌4例（30.8％ 4/16）.真菌、细菌及病毒性角膜炎分别平均住院29、21及15 d.结论 合并慢性泪囊炎、病毒性角膜炎为老年细菌及真菌性角膜炎重要病因,老年人病毒性角膜炎多为复发病例,老年人感染性角膜炎病程长,治疗迟,难治愈.老年人感染性角膜炎有其自身特点,应加强认识改善预后,降低发病率。Objective To investigate the pathogenic and etiological characteristics of infectious keratitis in the elderly.Method All 668 proven cases （671 eyes） of infectious keratitis in the elderly aged 60 years and older from January 2013 to December 2014 were retrospectively reviewed.Results The cases of infectious keratitis in the elderly which occupy 49.5% were major component in inpatient of the department of ocular surface disease, 402 patients （60.2%） were not treat regularly, 148 patients were in hospital after onset 7 days, 154 cases （33.0%） had corneal lesions larger than 5mm, 81 （71.7%） bacterial keratitis in the elderly were complicated by dacrocystitis or viral keratitis, 31 （21.2%） fungal keratitis in the elderly were complicated by viral keratitis, 277 （67.7%） viral keratitis were recurrence.65 cases （9.7%） which were of no effect or improved but not cured with medication were received operation.Causative agent were cultured as 26 fungi, half of them were fusarium species, and 16 bacteria in which there were 4 streptococcus salivarius （30.8%） separately.The mean course of disease to fungal and bacteria and viral keratitis in our hospital were 18 days and 13 days and 7 days respectively.Conclusions Chronic and recurrent ocular surface diseases play an important role in the infectious keratitis in the elderly.Infectious keratitis in the elderly has long course of disease.They treat lately in early stage and hardly to cure in later period.Fungal keratitis in the elderly has its own feature and should be known and study more to reduce its morbidity and improve its prognosis.

关 键 词：感染性角膜炎 老年人 病因 病原学 

分 类 号：R446.5[医药卫生—诊断学]