摘要
目的探讨不同真菌菌属所致角膜炎的临床特点及转归差异。方法收集2011年8月至2015年3月我院真菌培养阳性的角膜炎患者共96例（96眼）,其中,镰刀菌43例,曲霉菌31例,链格孢霉17例,念珠菌5例,分别记录患者植物性外伤史、病程、临床特点、治疗方式及转归。对上述观察指标进行比较,采用SPSS 19.0软件进行统计学分析。结果 96例患者中有植物性外伤史者34例（35.4%）,其中镰刀菌感染患者中25.6%有植物性外伤史,曲霉菌35.5%,链格孢霉64.7%,念珠菌20.0%,不同菌属之间差异有统计学意义（χ~2=8.714,P=0.033）。组间比较镰刀菌与链格孢霉间差异有统计学意义（χ~2=8.031,P=0.005）。患者病程按照菌属从短到长依次为：念珠菌（5.40±3.36）d、镰刀菌（16.79±13.98）d、曲霉菌（19.35±13.16）d、链格孢霉（27.59±20.68）d,不同菌属间差异有统计学意义（χ~2=14.407,P=0.002）,组间比较念珠菌病程与其他菌属差异均有统计学意义（均为P〉0.05）。镰刀菌感染以单纯药物治疗与角膜板层切除术治疗为主,药物治愈率为78.6%;曲霉菌感染以角膜板层切除术和角膜移植术治疗为主,药物治愈率62.5%;链格孢霉和念珠菌感染主要以单纯药物治疗为主,药物治愈率分别为90.0%、100.0%。结论链格孢霉感染多由植物性外伤引起,临床体征轻,药物治疗效果好;念珠菌感染发展快,药物治疗效果好;镰刀菌与曲霉菌感染临床体征重,镰刀菌常需尽早行角膜板层切除术,曲霉菌常需行角膜移植术治疗。
Objective To explore the differences of keratitis caused by four different fungal species in clinical characteristics and outcomes.Methods Ninety-six eyes of 96 patients diagnosed as fungal keratitis in our hospital were collected in this study,in which 43 cases were Fusarium spp,31 cases were Aspergillus spp,17 cases were Altemaria spp 5 cases were Candida spp.The plant trauma history,disease duration,clinical signs treatment and prognosis were recorded.Those above indexes were statistically analyzed with SPSS 19.0 software.Results The plant trauma history were found in 34 patients（35.4%）,in which Fusarium accounted for 25.6%,Aspergillus for 35.5%,Altemaria for 64.7%Candida for 20%,the difference among those species was statistically significant（χ~2=8.714,P=0.033）,and there was statistical difference between Fusarium and Altemana（χ~2=8.031,P =0.005）.From short to long duration as followed,Candida（5.40±3.36） days,Fusarium（16.19 ±13.98） days Aspergillus（19.35±13.16） days,Altemaria（27.59±20.68） days,the difference was statistically significant（P =0.002）,and the duration of Candida spp was statistically shorter than that of other species（all P 〈 0.05）;There was statistical difference between Fusarium and Altemaria（P =0.010）.Clinical signs were different among those fungal species.Corneal ulcer area,depth of invasion,hypopyon incidence in Altemaria spp were statistically less than those of other species（all P 〈 0.05）,and there was no statistically significant difference in other clinical signs（all P 〉 0.05）.Fusarium keratitis was mainly treated with medication and lamellar keratectomy,and the medication cure rate was 78.6%.Aspergillus keratitis was mainly treated with lamellar keratectomy and penetrating keratoplasty,while the medication cure rate was 62.5%.Altemaria and Candida keratitis were mainly treated with medication,and the cure rate were 90.0%,100.0%,respectively.Conclusion Altemaria keratitis with mild clinical signs is often caused by plant trauma
出处
《眼科新进展》
CAS
北大核心
2016年第3期250-254,共5页
Recent Advances in Ophthalmology
基金
武汉市卫计委临床医学科研项目(编号:WX13C50)
爱尔眼科医院集团科研基金项目(编号:AF2013006)~~
关键词
真菌性角膜炎
临床特点
转归
fungal keratitis
clinical characteristics
prognosis
