摘要
目的研究福建地区真菌性角膜炎（fungal keratitis，VK）的流行病学和临床表现特点。方法回顾性分析2006年7月至2008年7月住院确诊的FK患者176例，分析其流行病学和临床表现方面的特点。结果10～12月发病率最高，农村居民106例（60．2％），男女患病率比为1．5：1，41～60岁为发病集中年龄，仅39．8％有明确外伤史，在153例先于外院就诊的患者中，仅有28例（18．3％）接受过角膜刮片和（或）真菌培养检查；菌丝苔被、伪足、前房积脓发生率分别为94％、65％和55％；菌属鉴定结果：前两位分别为：镰刀菌属（60．4％）和曲霉菌属（25．4％）；保守治疗治愈率80．9％，眼球保存率为97．5％；镰刀菌属菌丝在角膜中的生长方式表现为水平、斜行和垂直生长，曲霉菌属全部表现为斜行和垂直生长。结论福建地区FK在10-12月为高发期，多发于中老年的农村居民，多数无明显诱因发病，菌丝苔被、伪足和前房积脓依次为前三位临床体征，致病菌属以镰刀菌属和曲霉菌属为主，它们在角膜内地生长方式有所不同，大多数药物保守治疗有效，加上手术治疗绝大多数能保住眼球。基层医院对本病的诊治有待加强。
Objective To study the epidemiology and clinical characteristics of fungal keratitis （FK） in Fujian province.Methods A total of 176 hospitalized cases of fimgal keratitis from July 2006 to July 2008 were retrospectively reviewed for epidemiology and clinical characteristics.Results The peak of FK occurred in Oct.to Dec.One hundred and six （60.2%） patients were rural resident.The ratio between the male and female patients was 1.5.1.Most patients were 41-450 years old.The history of trauma was present in 70 patients （39.8%） .Only 28 patients （18.3%）received etiological examination in the 153 patients hospitalized in other hospital first.The incidence rate of mycelium lawn,pseudopodium and hypopyon was 94% ,65% and 55% respectively.Fusarium species were isolated the most frequently （60.4%）, followed by Aspergillus （25.4%） .The cure rate of conservative therapy was 80.9% .The ratio of preserved eyeballs was 97.5%.Fusarium grows in cornea horizontally, diagonally and vertically, while Aspergillus grow in cornea diagonally and vertically.Conclusions In Fujian province,the peak of FK occurred in Oct.to Dec.Most of patients were the middle and old-aged rural resident.There was no significant inducing factor in most patients.The most clinical sign of FK were mycelium lawn,pseudopodium and hypopyon.The Fusarium and AspergiUus species were the main pathogen of FK.The growth pattern in cornea is different between the Fusarium and Aspergillus species.Most of patients could be cured by conservative therapy and very few of eyeballs have to be enucleated plus surgery.The diagnosis and treatment for FK in the primary hospitals should be reinforced.
出处
《中国实用眼科杂志》
CSCD
北大核心
2009年第7期707-710,共4页
Chinese Journal of Practical Ophthalmology
基金
福建省卫生厅青年科研课题基金项目（2006-2-60）
