棘阿米巴角膜炎的实验诊断

LABORATORY DIAGNOSIS OF ACANTHAMOEBA KERATITIS

[目的 ]寻找棘阿米巴角膜炎快速诊断和棘阿米巴快速鉴定的方法。 [方法 ]10 %氢氧化钾 (KOH)湿封片镜检、棘阿米巴培养、倒置显微镜观察、病理切片H .E .染色和SPA染色检查。 [结果 ]角膜刮片及手术切除的角膜材料 ,经 10 %氢氧化钾湿封片镜检 ,前者检出 7例棘阿米巴角膜炎病例 ,后者确诊 5例 ;手术切除的角膜材料经培养 ,分离出 6株棘阿米巴 ;应用倒置显微镜直接观察 ,检出棘阿米巴的包囊、滋养体和棘刺。 [结论 ]应用 10 %KOH湿封片镜检可对棘阿米巴角膜炎作出快速诊断 ;通过倒置显微镜直接观察也可对棘阿米巴角膜炎在 2 0h内作出诊断 ;倒置显微镜可直接观察和鉴定棘阿米巴 ,方法简便、无污染、快速及实用。

Objective] To find a rapid method for diagnosing Acanthamoeba keratitis and identifing Acanthamoeba . [Methods] 10% potassium hydroxide(KOH) wet mount preparations, Acanthamoeba culture, inverted phase contrast microscopy,and pathological examination using H.E. staining and PAS staining. [Results]Using corneal scrapings and corneal materials obtained from surgery,7 cases and 5 cases of Acanthamoeba keratitis were diagnosed by 10% KOH wet mount preparations. 6 strains of Acanthamoeba were isolated in corneal materials of 6 cases by protozoa culture method. The cysts, trophozoites and pseudopods on the trophozoites of Acanthamoeba were directly observed under the inverted phase contrast microscope. The cysts and trophozoites of Acanthamoeba were seen by H.E. staining and PAS staining with 20 h. [Conclusion] Acanthamoeba keratitis could be rapidly diagnosed by 10% KOH wet mount preparations and inverted phase contrast microscopy. Acanthamoeba organisms could be directly observed and identified under inverted phase contrast microscope.