摘要
目的探究真菌性角膜炎患者角膜穿孔的发生率、临床特征及预后情况。方法回顾性系列病例研究。收集2004年1月至2014年9月就诊于青岛大学附属医院的625例真菌性角膜炎患者的临床资料，按照是否发生角膜穿孔分为穿孔组和未穿孔组，并对两组患者的病因、病原学特点、就诊时间、病灶特征等情况进行统计分析，同时对角膜穿孔患者的预后进行回顾性分析。结果真菌性角膜炎患者角膜穿孔的发生率为23．7％。角膜外伤史（r2=0．218，P=0．640）、角膜接触镜佩戴史（X2=0．268，P=0．605）及眼表疾病史（X2=0．353，P=0．553）在两组问的差异无统计学意义；而两组患者在局部用糖皮质激素（X2=14．251，P〈0．01）及合并糖尿病（X2=22．365，P〈0．01）的差异有统计学意义。此外，在致病真菌菌属、就诊前的发病天数方面亦存在差异有统计学意义（P〈0．05）。角膜病灶的大小、浸润深度、前房积脓在两组患者中差异有统计学意义（P〈0．01）。结论局部使用糖皮质激素与合并糖尿病病史的真菌性角膜炎患者多有角膜穿孔的发生。致病真菌菌属及就诊时间，角膜病灶的大小、深度、前房积脓可能是真菌性角膜炎角膜穿孔发生的重要危险因素。
Objective To analyze the incidence, clinical characteristics and prognosis of corneal perforation caused by fungal keratitis. Methods A total of 625 cases of fungat keratitis were retro- spectively reviewed and divided into two groups according to ocular perforation. The pathogenesis and pathogen were compared and analyzed. Also, the prognosis of patients with ocular perforation was reviewed. Results The incidence of ocular perforation in fungal keratitis patients was 23.7% in our hospital. The differences in corneal trauma （X2=0.218, P =0.640）, contact lens wear （X2=0.268, P = 0.605） and ocular surface diseases （X2=0.353, P =0.553） between these two groups were not signifi- cant. While, the differences in topical steroid use （Z2=14.251, P 〈0.01） and diabetes mellitus （Z2= 22.365, P 〈0.01） were significant. Moreover, there were significant differences in the pathogen, the time interval between presentation to our hospital and clinical features of corneal lesions （P 〈0.01）. Conclusions Progression of fungal keratitis to corneal perforation is relatively common. Patients at higher risk for progression to corneal perforation include patients using topical steroid, patients with diabetes mellitus, patients with Fasarium specie, patients possessing long time interval between presen- tation to our hospital, patients with large and deep corneal lesions and patients with hypopyon.
出处
《中国实用眼科杂志》
2015年第6期621-624,共4页
Chinese Journal of Practical Ophthalmology
基金
国家自然科学基金项目（81170825）
关键词
眼真菌感染
角膜炎
角膜穿孔
回顾性研究
Eye infection
Fungal
Keratitis
Corneal perforation
Retrospective study
