实验室诊断技术在真菌性角膜炎诊断敏感性的对比研究
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Comparison on the sensitivity of laboratory diagnosis technology in the diagnosis of fungal keratitis
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    摘要:

    目的:分析真菌涂片、真菌培养和病理检查在诊断真菌性角膜炎上的相关性及临床意义。

    方法:收集2012-01/2014-12诊断为真菌性角膜炎的患者110例110眼,对真菌涂片、真菌培养及病理检查结果进行回顾性分析总结。真菌涂片行角膜刮片,用10%氢氧化钾制成湿片镜检,同时行革兰染色镜检; 真菌培养采用马铃薯葡萄糖琼脂培养基(PDA)培养; 病理检查的标本为角膜移植切除手术标本,采用石蜡切片,使用苏木素-伊红(HE)、六胺银、过碘酸-雪夫(PAS)染色镜检。

    结果:真菌涂片阳性者50例(45.5%); 真菌培养阳性者55例(50.0%); 病理检查阳性者88例(80.0%)。真菌涂片与病理检查均为阳性者50例,真菌涂片与病理检查均阴性者22例,真菌涂片与病理检查的符合率为65.5%。真菌培养与病理检查均为阳性者55例,真菌培养与病理检查均阴性者22例,真菌培养与病理检查的符合率为70.0%。真菌涂片结果阴性者60例中,有38例经病理检查确诊为阳性,占63.3%; 真菌培养结果阴性者55例中,有33例经病理检查确诊为阳性,占60.0%。

    结论:病理检查的敏感性最好,真菌涂片、真菌培养及病理检查联合应用能够提高真菌性角膜炎的诊断水平,降低漏诊、误诊。

    Abstract:

    AIM: To analyze the correlation and clinical significance of fungal smear, fungal culture and pathological examination in the diagnosis of fungalkeratitis.

    METHODS:One hundred and ten cases(110 eyes)with fungal keratitis from January 2012 to December 2014 were collected. The results of fungal smear, fungal culture and pathological examination results were analyzed retrospectively. Fungal smear was detected by 10% KOH wet microscopy and gram staining microscopy. Fungal culture was used potato dextrose agar(PDA)medium. The specimens of pathological examination were from corneal transplantation surgery. paraffin section, HE and hexamine silver and PAS staining was used in the pathological examination.

    RESULTS:Of the 110 cases of fungal keratitis, fungal smear positive were observed in 50 cases(45.5%), fungal culture positive were observed in 55 cases(50.0%); pathological examination positive were observed in 88 cases(80.0%). Fifty cases were both fungal smear and pathological examination positive and 22 cases were both fungal smear and pathological examination negative. The coincidence rate of fungal smear and pathologic examination was 65.5%. Fifty-five cases were both fungal culture and pathological examination positive and 22 cases were both fungal culture and pathological examination negative. The coincidence rate of fungal culture and pathologic examination was 70.0%. In the 60 cases of fungal smear negative results, 38 cases(63.3%)were confirmed positive through pathological examination. In the 55 cases of fungus culture negative results, 33 cases(60.0%)were confirmed positive by pathological examination.

    CONCLUSION:The accuracy of pathological examination is the highest. The combined application of fungal smear, fungal culture and pathological examination can improve the diagnostic accuracy of fungal keratitis.

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陈鹏飞,秦晓怡,毛丽萍,等.实验室诊断技术在真菌性角膜炎诊断敏感性的对比研究.国际眼科杂志, 2015,15(8):1322-1326.

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  • 收稿日期:2015-04-30
  • 最后修改日期:2015-07-15
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  • 在线发布日期: 2015-08-05
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