兔玻璃体内注射氟康唑治疗外因性真菌性眼内炎疗效观察  

Efficacy of intravitreal fluconazole on exogenous fungal endophthalmitis

作　　者：沈丽君[1] 陈钦元[2] 徐明[1] 秦要武[1] 

机构地区：[1]温州医学院附属眼视光医院,325003 [2]复旦大学医学院附属眼耳鼻喉科医院,200031

出　　处：《眼科研究》2002年第5期431-433,共3页Chinese Ophthalmic Research

基　　金：浙江省卫生厅科研基金资助 (SWS0 0 0 0 2 )

摘　　要：目的　评估兔玻璃体内注射氟康唑治疗外因性真菌性眼内炎的效果。方法　大白兔玻璃体内接种白色念珠菌后不同时间玻璃体内注射氟康唑 10 0 μg或二性霉素B 5 μg,以间接检眼镜检查、玻璃体腔穿刺真菌培养及组织学检查等方法评估药物的疗效。结果　早期用药 ( 1h、18h) 2天时玻璃体仍清晰 ,与对照组比较存在显著性差异 ,此后玻璃体进行性混浊 ,与对照组比较无显著性差异 ;后期用药 ( 3天、5天 )玻璃体混浊仍继续进展 ,与对照组比较无显著性差异。真菌培养阳性率仅为 11 1%。感染眼标本光镜下均见玻璃体腔内形成霉菌性脓疡 ,并见PAS染色 ( +)的菌丝及孢子。结论　玻璃体内注射氟康唑治疗外因性真菌性眼内炎无明显疗效 ,玻璃体穿刺真菌培养阳性率较低 ,治疗上应以联合玻璃体切割术为宜。ObjectiveTo investigate the efficacy of intravitreal fluconazole in treating exogenous fungal endophthalmitis in rabbit.MethodsAlbino rabbits were infected with an intravitreal inoculation of 1,000 CFU of susceptible Candida albicans and received treatment at random with intravitreal injection of fluconazole 100μg or Amphotericin B 5μg in different time after inoculation,or no treatment.The effect was assessed within 4 weeks after treatment by funduscopy,quantitative vitreous culture,and Histopathology.ResultsVitreous was clearer in the early treatment groups (1,18 hours) than that of control group on 2 days after inoculation,then there was progressive vitreous clouding.Vitreous clouding progressed in the later treatment groups (3,5 days) after therapy and no significant difference compared with the control group.The positive rate of vitreous puncture culture was low.Histopathologic examinations showed vitreous abscesses and fungal elements.ConclusionIntravitreal fluconazole is useless for treatment of exogenous candida endophthalmitis,the positive rate of vitreous puncture culture is low.

关 键 词：疗效 治疗 氟康唑 外因性真菌性眼内炎 玻璃体内注射 抗真菌药 

分 类 号：R771.2[医药卫生—眼科]