糖皮质激素在感染性角膜病治疗中的应用  

Application of glucocorticoids on the treatment of infectious keratopathy

作　　者：唐静[1] 邓应平[1] 孙旭光 Tang Jing;Deng Yingping;Sun Xuguang(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu 610041,China;Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Key Laboratory of Ophthalmology and Visual Scienses,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,China)

机构地区：[1]四川大学华西医院眼科,成都610041 [2]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所眼科学与视觉科学北京市重点实验室,100005

出　　处：《国际眼科纵览》2022年第1期45-50,共6页International Review of Ophthalmology

基　　金：四川省科技厅重点研发项目(面上)(2021YFS0221)。

摘　　要：感染性角膜炎是引起角膜盲的主要原因之一,治疗以抗感染为主,而糖皮质激素的使用指征仍存在争议。在不同类型病原体感染角膜炎中,选择合适的使用时机,才能使糖皮质激素获得较好的抗炎效果,同时减少其副作用的发生。在细菌性角膜炎的治疗中,建议在抗生素有效治疗48小时后使用糖皮质激素,以减少角膜瘢痕的形成。对于病毒性角膜炎,糖皮质激素使用范围仍是基质炎型和内皮炎型;糖皮质激素极易导致真菌性角膜炎加重,仅在确认真菌感染完全控制之后方可使用;有关棘阿米巴感染性角膜炎治疗中糖皮质激素的治疗作用,虽然获得了基础研究上的进展,但是使用的时机上尚未达成共识。Infectious keratitis is a risk of corneal related blindness,and anti-infection is the main treatment approach,while the glucocorticoid therapy remains controversial.The appropriate utilization of the glucocorticoid in different infectious keratitis could be helpful for the anti-inflammatory effect and release the complications.It was suggested that the glucocorticoid could be used in the bacterial keratitis after 48 hours antibiotic treatment,which can reduce the formation of corneal scarring.The glucocorticoid used in the viral keratitis is still limited in the stromal and endothelial infection,which could obviously alleviate the inflammation.Glucocorticoids are easily worsen the exacerbation of fungal keratitis,so it could be only used after the fungal infection was controlled.Glucocorticoid utilized in acanthamoeba keratitis has gotten some progress in the basic research,but still no consensus on the timing of use.

关 键 词：感染性角膜病 糖皮质激素 

分 类 号：R772.21[医药卫生—眼科]