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目的 :评价共焦显微镜 (confocalmicroscopy)在棘阿米巴性角膜炎 (acanthamoebakeratitis)临床诊断 ,尤其是早期诊断中的应用价值。方法 :对临床拟诊为棘阿米巴性角膜炎患者 2 3例进行共焦显微镜检查 ,并同时行角膜涂片及棘阿米巴原虫培养检查 ,对两种检查方法的结果进行比较。结果 :2 3例患者中 ,13例共焦显微镜检查可见棘阿米巴包囊和 /或神经炎表现 ,综合各项检查结果及临床表现 ,18例确诊为棘阿米巴性角膜炎 ,共焦显微镜的阳性率为 5 6 5 %。在 5例表现为上皮性及浅基质病变的早期角膜炎患者 ,共焦显微镜检查 3例 (6 0 % )为阳性 ,刮片、培养各 1例 (2 0 % )为阳性。结论 :共焦显微镜检查是一种无创、快速和有效的活体检查手段 ,在棘阿米巴性角膜炎的诊断中 ,如同时结合实验室刮片及培养和患者临床情况可起到重要的辅助诊断作用 ,尤其是在棘阿米巴角膜炎的早期诊断中 ,可以起到更重要的作用
Objective: To evaluate the value of confocal microscopy in the clinical diagnosis, especially in the early diagnosis of acanthamoebaeratitis. Methods: Confocal microscopy was performed on 23 clinically diagnosed as acanthoeba acne keratitis, and corneal smear and culture of Acanthamoeba were also performed. The results of the two methods were compared. Results: Of the 23 patients, 13 cases were examined by confocal microscopy for the diagnosis of acanthamoeba cysts and / or neuritis. According to the results and clinical manifestations, 18 cases were diagnosed as Acanthamoeba keratitis, The positive rate of focal microscope was 56.5%. In 5 cases of early keratitis with epithelial and superficial stromal lesions, 3 cases (60%) were positive by confocal microscopy and one case (20%) by scraping and culture. CONCLUSIONS: Confocal microscopy is a noninvasive, rapid and effective means of biopsy. In the diagnosis of acanthramina keratitis, it can be an important adjunct to laboratory smears and their clinical condition Diagnostic effects, especially in the early diagnosis of Acanthamoeba keratitis, may play a more important role