单疱病毒性角膜炎角膜知觉变化的临床研究

Corneal touch sensitivity in palients with herpes simplex virus keratitis

目的探讨不同类型单疱病毒性角膜炎患者角膜知觉的变化及其恢复情况。设计病例对照研究。研究对象单疱病毒性角膜炎病人74例78眼,70只对侧健康眼为对照眼。方法利用Cochet-Bonnet角膜感觉仪,对单疱病毒感染的角膜分别测量上方、下方、鼻侧、颞侧角膜缘内1mm处及角膜中央区的角膜知觉,测量患者对侧健眼相应位置的角膜知觉用于对照分析。主要指标角膜知觉敏感度。结果单疱病毒性角膜炎各型均引起角膜知觉下降,其下降程度:浅表型>基质内皮型>瘢痕型,各型角膜炎与健康眼相应位点角膜知觉比较均有显著性差异(P均<0.01)。三种不同类型角膜病变组之间角膜知觉差异无统计学意义。同一类型角膜炎不同位点角膜知觉无显著性差异。结论单疱病毒性角膜炎各型均引起角膜知觉下降,浅表型为著,愈后有恢复趋势。

Objective To investigate the difference of corneal touch sensitivity in patients with different types and stages of herpes simplex virus keratitis. Design Case-controlled study. Participants Seventy-four patients （78 eyes） with keratitis, 70 healthy eyes. Methods Corneal sensitivity was examined with Cochet-Bonnet aesthesiometer in keratitis and healthy eyes as control. The points of corneal sensitivity being tested arel2, 3, 6 and 9 o＇clock position 1 mm away from the corneal edge as well as the center cornea. Main Outcome Measures The corneal touch sensitivity. Results Corneal sensitivity was significantly reduced in patients with herpes simplex virus keratitis. The type of epithelium lesion keratitis was the greatest loss of corneal sensitivity, followed by disciform, endothelium keratitis, and corneal scar type of keratitis. There was significant difference in the corneal sensitivity between the eyes with those types of keratitis and the control eyes. But there were no significant difference in corneal sensitivity among the three types of keratitis. Conclusions Corneal sensitivity is reduced in three types of herpes simplex virus keratitis, mostly in epithelium lesion keratitis, but can be recovered in scar stage of keratitis.