真菌性角膜炎预后影响因素分析

Analysis of affecting factors for treatment outcome in fungal keratitis

目的:分析影响真菌性角膜炎预后的相关因素,为真菌性角膜炎治疗决策提供依据。方法:选择我院诊治的105例105眼真菌性角膜炎患者,通过评估临床体征、实验室检查及治疗情况等对真菌性角膜炎的预后影响因素进行统计分析。结果:选取105眼中49眼药物治疗治愈(46.7%);30眼(28.6%)药物治疗有效,上皮延迟愈合,26眼(24.8%)治疗失败。结论:抗真菌治疗开始于症状出现7d以后、初诊病灶浸润面积>16mm2、前房积脓>2mm、菌种鉴定为镰孢菌的真菌性角膜炎患者药物治疗预后较差。

AIM： To investigate the affecting factors that can serve as prognostic indicators of treatment outcomes, providing the first hand information for decision-making in therapy of fungal keratitis. METHODS： Totally 105 cases（105 eyes） with fungal keratitis were enrolled, characteristics at diagnosis, laboratory examinations and treatment responses were analyzed statistically to estimate the relative risk of the main prognostic variables. RESULTS： Among the 105 cases analyzed in the study, 49 eyes （46. 7%） were successfully cured, 30 eyes （28.6%） had slow- healing ulcers and 26 eyes （24.8%） were refractory to primary treatment. CONCLUSION： The predictors of treatment failure are antifungal therapy begin at more than 7 days after symptoms appeared, ulcers that exceeded 16 mm2, the presence of hypopyon that more than 2 mm and identification of Fusarium.