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目的探讨沙眼临床特征,选择适用于临床病因学诊断的实验室检查方法。设计回顾性病例系列。研究对象2003年1月至2006年8月间在北京同仁医院眼科中心临床诊断为沙眼的患者61例。方法沙眼诊断标准参照国内1979年制定的沙眼分期标准,对患者的一般情况、临床表现和实验室检查结果进行了回顾性分析。实验室检查包括结膜刮片查找包涵体、沙眼衣原体抗原检查和PCR检查。主要指标角结膜临床体征,结膜刮片、沙眼衣原体抗原及PCR检查结果。结果临床诊断沙眼患者61例中,男性28例,女性33例,平均年龄(29.05±19.99)岁;Ⅰ、Ⅱ和Ⅲ期患者分别占88.5%、8.2%和3.3%。刮片检查包涵体阳性检出率11.5%;沙眼衣原体抗原检查阳性检出率为68.9%;PCR检查阳性检出率为78.7%,抗原及PCR检查的检出率高于刮片检出率(P=0.00)。结论门诊沙眼患者主要为Ⅰ期表现,病变较轻,临床需选择敏感的抗原或PCR检查辅助沙眼病因学诊断。
Objective To investigate the clinical features of trachoma and to choose the laboratory test method suitable for the diagnosis of clinical etiology. Design retrospective case series. The subjects were 61 cases of trachoma clinically diagnosed in Beijing Tongren Hospital Eye Hospital from January 2003 to August 2006. Methods The diagnostic criteria of trachoma were retrospectively analyzed according to the standard of trachoma in 1979 and the general situation, clinical manifestations and laboratory findings of the patients. Laboratory tests include conjunctival smears to find inclusion bodies, C. trachomatis antigen tests, and PCR tests. The main indicators of conjunctival clinical signs, conjunctival smears, Chlamydia trachomatis antigen and PCR test results. Results Of the 61 clinically diagnosed trachoma patients, 28 were male and 33 were female, with an average age of (29.05 ± 19.99) years; 88.5%, 8.2% and 3.3% of patients were in stages I, II and III, respectively. The positive detection rate of inclusion body of smear was 11.5%. The positive detection rate of Chlamydia trachomatis antigen was 68.9%. The positive detection rate of PCR was 78.7%. The detection rate of antigen and PCR was higher than the detection rate of smear P = 0.00). Conclusions Outpatients trachoma mainly stage Ⅰ performance, lesion is mild, the clinical need to choose sensitive antigen or PCR examination to aid the diagnosis of trachoma.