CAJ | 학술논문

目的分析真菌性角膜炎患者的致病菌属分布情况,为临床诊断和治疗提供数据.方法收集2005年7月至2010年12月期间在山东省眼科医院确诊为真菌性角膜炎的352份角膜溃疡组织刮片以及术中切除角膜组织标本,采用沙保弱培养基,28℃条件下湿盒内培养7d,根据真菌菌落外观、菌丝、孢子形态、孢子排列方式及菌细胞形态进行菌种鉴定.并对送检角膜刮片和术中切除角膜组织标本真菌培养的阳性率、菌属分布、季节分布以及患者的来源、性别比例、年龄分布和职业等情况进行回顾性分析.对不同年份菌株检出率、菌株的季节分布差异等指标采用卡方检验方法进行分析.结果 352份确诊为真菌性角膜溃疡的培养标本中,真菌培养阳性334株,阳性率94.9％.其中203份角膜刮片标本培养阳性187份,阳性率92.1％；149份术中切除角膜组织培养阳性147份,阳性率为98.7％.分离到的菌株中镰刀菌属最多见,共211株(63.2％).其次为曲霉菌属,共47株(14.1％).培养阳性菌株季节分布特点:1至3月份共培养出48株(14.4％)；4至6月份共培养出48株(14.4％)；7至9月份共培养出64株(19.2％),10至12月份共培养出174株(52.0％),四者比约1∶1∶1.3∶3.6,差异无统计学意义(x2=3.360,P=0.339).334例培养阳性患者中男女比例为2.04∶1；平均年龄为(48±22)岁.发病群体农民217例(65.0％),其他职业117例(35.0％).334例阳性患者中289例(86.5％)患者来自山东省内,45例(13.5％)患者来自山东省以外省份.结论镰刀菌属是山东地区真菌性角膜炎最主要的致病菌,10～12月份是真菌性角膜炎的好发季节.真菌性角膜炎标本的病原体培养阳性率高,对临床诊治具有重要作用.
목적 분석진균성각막염환자적치병균속분포정황,위림상진단화치료제공수거.방법 수집2005년7월지2010년12월기간재산동성안과의원학진위진균성각막염적352빈각막궤양조직괄편이급술중절제각막조직표본,채용사보약배양기,28℃조건하습합내배양7d,근거진균균락외관、균사、포자형태、포자배렬방식급균세포형태진행균충감정.병대송검각막괄편화술중절제각막조직표본진균배양적양성솔、균속분포、계절분포이급환자적래원、성별비례、년령분포화직업등정황진행회고성분석.대불동년빈균주검출솔、균주적계절분포차이등지표채용잡방검험방법진행분석.결과 352빈학진위진균성각막궤양적배양표본중,진균배양양성334주,양성솔94.9％.기중203빈각막괄편표본배양양성187빈,양성솔92.1％；149빈술중절제각막조직배양양성147빈,양성솔위98.7％.분리도적균주중렴도균속최다견,공211주(63.2％).기차위곡매균속,공47주(14.1％).배양양성균주계절분포특점:1지3월빈공배양출48주(14.4％)；4지6월빈공배양출48주(14.4％)；7지9월빈공배양출64주(19.2％),10지12월빈공배양출174주(52.0％),사자비약1∶1∶1.3∶3.6,차이무통계학의의(x2=3.360,P=0.339).334례배양양성환자중남녀비례위2.04∶1；평균년령위(48±22)세.발병군체농민217례(65.0％),기타직업117례(35.0％).334례양성환자중289례(86.5％)환자래자산동성내,45례(13.5％)환자래자산동성이외성빈.결론 렴도균속시산동지구진균성각막염최주요적치병균,10～12월빈시진균성각막염적호발계절.진균성각막염표본적병원체배양양성솔고,대림상진치구유중요작용.
Objective To analyze the distribution of pathogenic bacterium of the fungal keratitis patients for providing the data of clinical diagnosis and treatment.Methods From July 2005 to December 2010 in Shandong Eye Hospital there were 352 smears of corneal ulcers and corneal tissue exemplar removed in surgery from fungal keratitis patients.The all exemplars were cultured with the Sabouraud dextrose agar culture media in 28 ℃ under the humidor for 7 days.The strains was identified according to the appearance of fungal colonies,mycelium,spore shape,spore arrangement and fungal shape.And there did the retrospective analyses about the positive rate of fungal culture,genus distribution,seasonal distribution and sources of patients,sex ratio,age distribution and occupation.etc.Results There were 334 stock positive fungal culture in 352 cultured specimens from fungal corneal ulcers,the positive rate was 94.9％.There were 187 positive culture from 203 corneal scraping exemplars,the positive rate was 92.1％ ; there were 147 positive culture from 149 corneal tissue removed in surgery,the positive rate was 98.7％.The Fusarium strains was most common in all isolated strain,211 (63.2％).The Aspergillus was secondly 47 (14.1％).The character of seasonal distribution of culture positive strain:the 48 strains (14.4％) were cultivated from January to March; the 48 strains (14.4％) were cultivated from April to June; the 64 strains were cultivated (19.2％) from July to September; the 174 strains (52.0％) were cultured from October to December,the ratio were 1∶ 1∶1.3∶3.6 quarterly(x2 =3.360,P =0.339).The incidence of fungal keratitis were higher in the autumn and winter than in spring and summer.The ratio of the male and the female was 2.04∶ 1 in 334 culture-positive patients; the mean age was (48 ± 22) years old.The 217 (65％) came from farmer in the developed group,and the other 117 cases came from other occupations (35％).The 289 (87％) cases came from Shandong Province in 334 positive patients,the 45 cases (13％) came from other province of Province.Chi-square test method was used to analysis the differences of incidence of fungal keratitis among the four seasons using SPSS11.5.Conclusions The Fusarium is the most important pathogen in fungal keratitis in Shandong Province.The high positive culture rate of fungal keratitis specimens plays an important role in clinical diagnosis and treatment.