棘阿米巴角膜炎的临床诊断及实验检测.docVIP

精品论文 参考文献 棘阿米巴角膜炎的临床诊断及实验检测 许琴英 (广东医学院寄生虫学教研室 广东湛江 524023) 【摘要】目的　探讨简单、实用、有效的棘阿米巴角膜炎临床与实验室诊断方法。方法　观察本院5例棘阿米巴角膜炎感染的临床表现，通过湿封片或染色后镜检角膜刮片、分离培养棘阿米巴、行角膜组织病理学检查，分析棘阿米巴角膜炎的临床思维。结果　角膜刮片显微镜下观察到棘阿米巴包囊、滋养体和伪足，分离培养和组织活检能检测到阿米巴，5例患者棘阿米巴的诊断能得到确诊。结论　怀疑棘阿米巴角膜炎病例，应尽早行棘阿米巴病原学检测，对于棘阿米巴的早期诊断，防止误诊、早期治疗和预后有重要意义。 【关键词】棘阿米巴 角膜炎 诊断 临床 【中图分类号】R772.21 【文献标识码】A 【文章编号】2095-1752（2013）23-0379-02 Clinical diagnosis of acanthamoeba keratitis and its experimental tests Xu Qin-ying Department of Parasitology of Guangdong MedicalCollege, Zhanjiang 524023,China 【Abstract】purpose To explore a simple, practical effective method for clinical diagnosing Acanthamoeba keratitis and laboratory identifing Acanthamoeba. Methods Observed about 5 cases of acanthamoeba keratitis infection clinical manifestations in our hospital, and examined corneal scraping by 10% potassium hydroxide(KOH) wet-mount or dyeing. At the same time, Acanthamoeba was isolated and cultured from the corneal tissue, which would be analyse clinical thinking of acanthamoeba keratitis. Results The cysts,Trophozoites and pseudopods the Trophozoites of Acanthamoeba were directly observed under the microscope. Acanthamoeba culture and Corneal histopathology are positive, so 5 cases of acanthamoeba diagnosis can be confirmed. Conclusion Suspected of cases of acanthamoeba keratitis, acanthamoeba etiology detection is needed as soon as possible, for the early diagnosis of acanthamoeba has important significance to prevent misdiagnosis, early treatment and prognosis. 【Key words】Acanthamoeba Keratitis Diagnosis Clinical 棘阿米巴通过灰尘或污水侵入眼部，引起角膜溃疡、色素膜炎等。由于既往的患病率低，在早期诊断的认识和检查方法都缺乏经验，该病发现时多为晚期感染患者，再加上缺乏有效的治疗药物，故致盲率较高[1]。因此，对棘阿米巴角膜炎进行快速早期病原学检查并确诊，有助于棘阿米巴角膜炎患者的及时治疗和预后。 随着临床上对本病认识的加深及检查方法的完善，确诊患有本病的病感染人数在世界各国呈逐渐增多之势[2]。本研究回顾性地分析了本院5例感染棘阿米巴角膜炎患者的临床资料，探讨棘阿米巴在实验室检测以及临床诊断方法并形成经验，从实际病例引导临床思维，供广大临床医师思考。 1 资料与方法 1.1 临床资料：收集2010年～2012年本院送检的5例角膜炎患者，均为单眼发病，其中男性3例、女性2例，年龄38～62岁、平均