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目的 比较常用的3种检测单纯疱疹性角膜炎(HSK)辅助诊断方法的敏感性和临床实用性。方法6只新西兰白兔双眼接种1×105PFU单纯疱疹病毒I型(HSV-I)McKrea株。病毒接种后第8天应用无环鸟苷眼膏每2 h 1次,共4次。另外2只兔中1只兔双眼在角膜上划痕但不接种病毒,另1只兔双眼角膜接种曲霉菌作为阴性对照。在病毒接种后的3、9、21天,利用病毒分离、多聚酶链反应(PCR)和蛋白吸附膜快速单纯疱疹病毒I型抗原检测方法进行检测。结果 接种后第2天全部角膜出现典型的HSK点状或树枝状浸润,第5天出现地图状溃疡,第21天仍有2只角膜有持续性感染。抗病毒治疗1天后无明显好转。2只兔于接种后14和16天死亡。病毒分离方法只有接种后3天的泪液培养阳性,第9、21天的标本检测均为阴性。有11/12、11/12和6/8只角膜在接种后的第3、9、21天用PCR方法检测到了HSV-I DNA。蛋白吸附膜抗原检测在接种后的第3、9、21天的阳性率分别为12/12、12/12和3/8。结论 蛋白吸附膜快速HSV—I检测是一种快速、简便、经济的方法。其阳性结果与临床表现相吻合。
Objective To compare the sensitivity and clinical utility of three commonly used diagnostic tests for herpes simplex keratitis (HSK). Methods Six New Zealand white rabbits were inoculated with 1 × 105 PFU herpes simplex virus type 1 (HSV-I) McKrea strain. The application of acyclovir ocular paste once every 2 h on the 8th day after virus inoculation, a total of 4 times. The other two rabbits in a rabbit eyes were scratched on the cornea but not infected with the virus, and the other rabbit corneal aspergillus inoculation as a negative control. The virus was isolated, polymerase chain reaction (PCR) and protein adsorption membrane rapid herpes simplex virus type I antigen detection method 3,9,21 days after virus inoculation. Results On the 2nd day after inoculation, all the corneas showed typical dot or dendritic infiltration of HSK. At the fifth day, there appeared map-like ulcer. On the 21st day, there were still 2 consecutive corneal infections. Antiviral treatment after 1 days no significant improvement. Two rabbits died on days 14 and 16 after inoculation. Virus isolation method only 3 days after inoculation of tear culture positive, the first 9,21 days were negative specimens. There were 11, 12, 11/12 and 6/8 corneas HSV-I DNA was detected by PCR method on the 3rd, 9th and 21st days after inoculation. The positive rates of protein adsorption membrane antigen detection on the 3rd, 9th and 21st days after inoculation were 12/12, 12/12 and 3/8, respectively. Conclusion The rapid HSV-I detection of protein adsorption membrane is a rapid, simple and economical method. The positive results are consistent with clinical manifestations.