棘阿米巴角膜炎的实验室检查和临床诊断

Laboratory experiments and clinical diagnosis of Acanthamoeba keratitis

目的:为了解棘阿米巴角膜炎的临床病程特征;;采用简便实用的实验室检查方法对棘阿米巴角膜炎进行病因诊断。方法:对棘阿米巴角膜炎患者13例(13只眼)各病程阶段的特征性眼表现;;通过角膜刮片材料镜检;;阿米巴分离培养及角膜病理确诊。结果:与戴角膜接触镜有关者4例;;非角膜接触镜配戴者9例。10%KOH湿封片镜检诊断阳性率81.25%;;棘阿米巴培养阳性率56.25%;;角膜病检阿米巴阳性率68.75%。结论:本病并非罕见;;除戴接触镜外;;许多因素可接触感染。10%KOH湿封片可对棘阿米巴角膜炎作初步诊断;;最后诊断须经原虫培养获得;;

Objective: To investigate a simple and practical laboratory experiment means for the etiological diagnosis of Acanthamoeba keratitis and study its clinical manifestations. Methods: Twelve cases (13 eyes) had been analyzed regard to its various clinical manifestations. At all stages of the infection, corneal cytological examination, isolation and cultivation of the amoeba were done from the infected cornea, the corneal tissue taken for pathological examination. Results: 4 cases were with contact lens related, 9 cases were induced by other factors. The positive rate of 10% potassium hydroxide was 81.25% in our cases. Acanthamoeba had been successfully isolated and cultivated from 56.25% of the patients and 68.75% of our series were confirmed by corneal cytological examination. Conclusions: Acanthamoeba keratitis is a fairly common disease. Besides that being induced by wearing contact lens, many other factors can also induce the infection. 10% potassium hydroxide can make early diagnosis but the latest result must be confirmed by isolation and cultivation of Acanthamoeba or corneal pathological examination.