PACK-CXL：治疗感染性角膜炎的角膜胶原交联  

PACK-CXL： corneal collagen cross-linking for infectious keratitis

作　　者：秦秀虹(综述)[1] 孙晓晶(综述)[1] 卢建民(审校)[1] Qin Xiuhong;Sun Xiaojing;Lu Jianmin(Department of Ophthalmology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院眼科,116011

出　　处：《中华实验眼科杂志》2018年第7期570-575,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81300737）;辽宁省自然科学基金项目（20170540274）

摘　　要：感染性角膜炎是视力不可逆性丧失的主要病因之一。随着多重耐药菌的出现，感染性角膜炎即使得到及时诊断和治疗，也常会导致角膜混浊，甚至溶解穿孔，因此亟待开发新的治疗手段。最近的研究表明，角膜胶原交联（CXL）可通过直接杀伤病原体和增强角膜耐酶消化性等机制发挥治疗感染性角膜炎的作用。为突显CXL在该方面的应用，第九届CXL年会将应用于感染性角膜炎的CXL定义为PACK-CXL。由目前文献推断，PACK-CXL对细菌性角膜炎，特别是角膜溶解穿孔具有良好的辅助治疗作用，对真菌性角膜炎和棘阿米巴性角膜炎的疗效则较弱，对病毒性角膜炎则可能具有恶化作用。本文将对CXL技术原理、技术操作、并发症及预防，PACK-CXL的治疗机制及其在细菌性角膜炎、真菌性角膜炎、棘阿米巴性角膜炎、病毒性角膜炎中的临床应用进展进行综述。Infectious keratitis is one of the leading causes of irreversible vision loss.With the emergence of multidrug-resistant pathogen, despite appropriate diagnosis and antimicrobial treatment, infectious keratitis can still result in corneal opacity and even melting and perforation.Therefore, it is imperative to develop novel treatment for infectious keratitis.More recently, several articles have demonstrated the effectiveness of collagen cross-linking （CXL） in treating infectious keratitis via direct antimicrobial activity and inhibition of corneal enzymatic degradation.In order to highlight the use of CXL for infectious keratitis treatment, a new term was proposed at the 9th CXL congress to rename its use in infections as photoactivated chromophore for infectious keratitis-CXL （PACK-CXL）. Based on the current literature, PACK-CXL appears to be effective for bacterial keratitis, especially on inhibiting corneal perforation.The effect was limited for fungal and amoebic keratitis, and maybe aggravative on viral keratitis.In this article, we will review the basic profile, technical operation, prevention of complication of CXL, the principle mechanism of PACK-CXL and its clinical application for bacterial, fungal keratitis, amoebic and viral keratitis.

关 键 词：角膜炎/治疗学 交联/治疗应用 综述 

分 类 号：R446.5[医药卫生—诊断学]