CAJ | 학술논문

目的探讨刮片细胞学检查诊断阿米巴角膜炎病原体形态特征.方法实验研究.收集1991年5月至2007年12月期间,首都医科大学附属北京同仁医院、北京市眼科研究所眼微生物室诊断为阿米巴角膜炎的病例159例,对其实验室检查与临床资料进行分析.采用姬姆萨染色法和湿片检查法,对角膜刮片细胞进行观察并照相记录.结果 159例阿米巴角膜炎通过姬姆萨染色刮片细胞学检出阿米巴病原131例(82.4%),阿米巴培养阳性110例(69.2%).刮片细胞学检出率明显高于培养检出率.刮片细胞学检查可观察到典型的滋养体、包囊、包囊前期、空包囊等病原形态,对临床诊断有重要意义.刮片中水肿溶解的角膜上皮细胞、渗出细胞、丝状真菌的关节孢子或厚膜孢子、空泡、脂滴及药物结晶等需要与病原体相鉴别.通过湿片法主要观察滋养体的运动状态.结论应用刮片细胞学检查法诊断阿米巴性角膜炎,观察到滋养体、包囊、包囊前期及空包囊典型特征对阿米巴性角膜炎有重要病原学诊断价值.
목적 탐토괄편세포학검사진단아미파각막염병원체형태특정.방법 실험연구.수집1991년5월지2007년12월기간,수도의과대학부속북경동인의원、북경시안과연구소안미생물실진단위아미파각막염적병례159례,대기실험실검사여림상자료진행분석.채용희모살염색법화습편검사법,대각막괄편세포진행관찰병조상기록.결과 159례아미파각막염통과희모살염색괄편세포학검출아미파병원131례(82.4%),아미파배양양성110례(69.2%).괄편세포학검출솔명현고우배양검출솔.괄편세포학검사가관찰도전형적자양체、포낭、포낭전기、공포낭등병원형태,대림상진단유중요의의.괄편중수종용해적각막상피세포、삼출세포、사상진균적관절포자혹후막포자、공포、지적급약물결정등수요여병원체상감별.통과습편법주요관찰자양체적운동상태.결론 응용괄편세포학검사법진단아미파성각막염,관찰도자양체、포낭、포낭전기급공포낭전형특정대아미파성각막염유중요병원학진단개치.
Objective To study the morphological characteristics in corneal smear of acanthamoeba keratitis. Methods Experimental study. From May 1991 to December 2007, in Department of Microbiology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, 159 cases with acanthamoeba keratitis were analyzed for the laboratory results and clinical data. Giemsa's stained smear and wet-mount preparation of 159 cases were observed, all the results of cytology be photographed as the records. Results Among the 159 cases with acanthamoeba keratitis, 131 patients (82.4%) were positive on smear, and 110 cases (69.2%) were positive in culture of amoeba. The detection positive rate of smear was apparently higher than culture. Typical trophozoites, pre-encystment trophozoites, mature cysts and empty cysts could be observed by smear. So it is an important method for the clinical diagnosis. The edema and dissolved corneal epithelial cells, exudate cells, arthrospore or chlamydoconidium of mycelial fungus, vacuolus, lipid droplet and medicine crystallization should be differentiated with the pathogen. The movement of trophozoites could mainly be observed through wet-mount preparation. Conclusion The detection of typical features of trophozoites, pre-encystment trophozoites, mature cysts and empty cysts by corneal smear is important for the etiological diagnosis of acanthamoeba keratitis.