真菌性角膜炎70例早期临床诊断分析

目的:分析70例真菌性角膜炎早期临床诊断结果,评价共焦激光显微镜在真菌性角膜炎早期临床诊断中的应用价值。方法:用共焦激光角膜显微镜对临床拟诊为真菌性角膜炎的70例患者进行检查,同时行涂片检查真菌菌丝及培养查真菌菌落,对三组结果进行比较。结果:在70例患者中,根据病史、临床表现确诊为真菌性角膜炎,其中共焦激光角膜显微镜的确诊率为94%(66/70),角膜刮片的确诊率为31%(22/70),培养查真菌菌落确诊率为20%(14/70)。激光共焦角膜显微镜检查检出率高于角膜组织刮片(χ2=29.615,P<0.01)及真菌培养(χ2=39.433,P<0.01)检查。结论:共焦激光角膜显微镜是一种无创、快速、有效的活体检查方法,在真菌性角膜炎的早期诊断、治疗和研究中将起重要作用。

Clinical analysis of early diagnosis of 70 cases of fungal keratitis

AIM: To analyze the early diagnosis of 70 cases of fungal keratitis and evaluate the application value of confocal laser corneal microscopy. METHODS: Confocal laser corneal microscopy, corneal tissue smears and fungal cultivation were performed on 70 patients of suspected fungal keratitis.The results were compared . RESULTS: Seventy patients were clinically diagnosed of fungal keratitis based on history, clinical signs. The positive rate of confocal laser corneal microscopy was 94% (66/70).The positive rate of corneal tissue smears was 31% (22/70).The positive rate of fungus cultivation was 20% (14/70). The positive rate of fungal keratitis detected by confocal laser corneal microscopy was higher than by corneal tissue smears (χ2=29.615,P<0.01) and fungal cultivation (χ2=39.433,P<0.01). CONCLUSION: Confocal laser corneal microscopy can be a non-invasive, rapid and effective imaging technique, and it is helpful in the early diagnosis ,treatment and study of fungal keratitis.