摘要
目的探讨兔眼角膜在感染真菌后的自然病情转归的特点。方法 10只新西兰白兔(20眼)作成真菌性角膜炎动物模型,成模后不用任何抗真菌治疗。每天观察兔眼角膜结膜的改变,分别记录成模后不同时间角膜透明度、新生血管和混合充血的情况,同时行菌丝涂片检查。分别于感染后3、7、15、30d 时行病理学和超微结构检查。回顾分析了35例人真菌性角膜炎患病后治疗过程和新生血管形成的时间,并与兔眼进行比较。结果兔眼感染真菌后初期出现角膜溃疡,并伴有前房炎症反应。第7天开始形成角膜新生血管,病情开始转向稳定,15d 后有好转趋势,到第30天时病情明显好转最终达到自愈,仅留下角膜白斑。第30天时真菌菌丝消失。人眼角膜新生血管的形成时间明显晚于兔眼(生存率分析,P<0.01)。结论兔眼真菌性角膜炎的转归与人眼有较大的差异,而且有自愈的趋势,可能与新生血管的长入时间不同,及眼表环境受药物影响有关。从而提示角膜新生血管长人对真菌生长可能有抑制作用;临床上在未明确角膜炎症的性质前,应注意慎用激素和抗生素。
Purpose To explore the outcome of mycotic keratitis on the lagophthalmos without any therapy. Methods 10 New Zealand rabbits, 20 eyes were infected by epiphyte. The transparence of cornea , new blood and the conjunctival reaction were examined by slit lamp every day. The results of day 1,3,7, 10, 15,30 were registered , and the epiphyte were examined by light microscope at same time. The pathological examination and ultrastructure examination have been performed at the day 3,7,15,30 on two eyes. During this period no medical treatment been done. Reviewed 35 patients who suffered mycotic keratitis. Results The gray ulcers formed on the 2nd day after infection, and the inflammation in anterior chamber and iris occurred at the same time. On the 7th day many new blood vessels grown into the cornea from the pripheral part were observed. The state of the infection were stable. On the 15th day, the symptoms of keratitis were relieved. On the 30th day , the affected area tend to be a corneal blaze , the keratitis improved. In this time no epiphytes were found by ultrstructure and pathological examination. The corneal neovascularization of human were later than the rabbit. Conclusion The outcome of the mycotic keratitis on rabbit＇ s eye were different from humans. It perhaps related to the different time of the formation of neovaseularization and the medical intervention on the ocular surface.
出处
《中国眼耳鼻喉科杂志》
2005年第5期284-286,i0002,共4页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
山东大学科技局立项课题(济科合字2002第39-2号)
