动态浊度法建立及测定角膜真菌感染标本初步探究-.docVIP

动态浊度法建立及测定角膜真菌感染标本初步探究* 　 作者：刘宏伟△，王香兰，彭淑玲，周 毅 【摘要】 目的 建立动态浊度法，研究角膜真菌感染的检测。方法 分别测定葡聚糖标准品、内毒素标准品、真菌标准株(烟曲菌、串珠镰刀菌和茄病镰刀菌)及细菌标准株(绿脓杆菌、金黄色葡萄球菌)，测定19例临床标本。结果 葡聚糖的浓度时间曲线为双曲线，时间反应曲线显示反应速率较低。内毒素的浓度时间曲线为直线，时间反应曲线显示反应速率较高。三种真菌的浓度时间曲线和时间反应曲线与葡聚糖的相似，革兰阴性菌（绿脓杆菌）的浓度时间曲线和时间反应曲线与内毒素的相似，革兰阳性菌（金黄色葡萄球菌）没有反应。临床19例标本，根据其浓度时间曲线和时间反应曲线的形态，11例确诊为真菌感染，8例为革兰阴性细菌曲线，为真菌和细菌的混合感染。结论 动态浊度法可用于角膜真菌感染的检测，但对细菌-真菌混合感染不能确诊。 【关键词】 动态浊度法；真菌；角膜；葡聚糖 【Abstract】 Objective To establish the turbidimetric kinetic assay and study the measurement of fungus infection in corneal specimen.Methods Glucan， endotoxin， fungus(Aspergillus fumigatus， Fusariun　moniliforme and Fusariun solani) and bactiria(Pseudomonas aeruginosa and Staphylococcus aureaus) were measured. 19 clinic specimens were also measured.Results The concentration-time curve of glucan was hyperbola　and its time-reaction curve had low reaction rate. The concentration-time curve of endotoxin was beeline and its time-reaction curve had high reaction rate. The concentration-time curve and time-reaction curve of 3 fungi were same as that of glucan. The concentration-time curve and time-reaction curve of G- bacterium(Pseudomonas aeruginosa) were as same as that of endotoxin. The G+ bacterium(Staphylococcus aureaus) had no reaction. According the concentration-time curve and time-reaction curve， 11 specimens were diagnosed fungi and 8 specimens were co-infection of fungi and bacteria.Conclusion Fungi infection in cornea could be diagnosed by turbidimetric kinetic method. Co-infection of fungi and bacteria could not be diagnosed by this method. 【Key words】 turbidimetric kinetic method；fungus；cornea；glucan 角膜真菌感染的诊断较难，如不能及时治疗，对患者造成损害，因此快速诊断非常必要。真菌的诊断一般采用镜检和培养的方法，镜检较快，但漏检率较高，真菌培养的方法，检出率较高，但时间较长。我们使用鲎试剂与真菌的葡聚糖反应的原理，建立动态浊度法并对角膜标本进行真菌测定。 1 材料与方法 1.1 试剂 葡聚糖标准品(031222，规格：300μg/ml)，鲎试剂（批号040532，灵敏度：0.25Eu/ml）购自厦门鲎试剂厂，内毒素标准品（批号2002-7）和检测用水(批号2003-3)购自中国药品生物制品检定所。 1.2 仪器 BET-72细菌内毒素测定仪、振荡器（天津大学无线电厂），超声波处理器、离心机（Beckman公司）。 1.3 葡聚糖和内毒素的浓度-时间曲线 1.3.1