摘要
目的 研究利用眼科用共焦显微镜鉴别诊断不同真菌性角膜炎的可行性。方法１８只新西兰白兔均分为３组，右眼分别接种白色念珠菌、烟曲霉菌和腐皮镰刀菌。接种时，去除角膜中央区５ｍｍ直径的上皮，滴新鲜培养的１×１０７个细胞／ｍｌ的白色念珠菌悬浮液，或涂上新鲜培养的烟曲霉菌或腐皮镰刀菌孢子，盖上软性接触镜，行睑裂缝合。在角膜感染后的第５，１０和１５天时，行共焦显微镜检查、真菌涂片检查和病理切片检查。结果 感染早期（１～５天）炎症反应明显，中期（５～１０天）炎症逐渐减轻，１０～１５天角膜形成疤痕而自愈。烟曲霉菌和腐皮镰刀菌的病程较迁延，反应较白色念珠菌重。共焦显微镜下，感染的白色念珠菌早期主要呈现芽孢状，成高亮度结构，以后发展成具有大量分支的树枝状结构，再发展成链状结构。感染１０天后未见任何真菌结构。烟曲霉菌的菌丝在早期则呈较白色念珠菌菌丝粗但分支相对较少的明亮的树枝状结构。中期以后其分支减少并变长，它在角膜组织中保留的时间较白色念珠菌长。在感染早期，腐皮镰刀菌则表现为蚯蚓状结构，以后发展为分支很少的粗短树枝状结构，其分支在３种真菌中最少但直径最粗。真菌涂片和组织学检查的结果与共焦显微镜检查相符。结论
Objective To evaluate the possibility of distinguishing among three fungal species using confocal microscope in the living eye. Mathods 18 rabbits were divided into three groups. Their right Corneas were inoculated with three different fun- gal species. The central corneal epithelium was removed within a 5 mm diameter and an aliquot of 1 × l07 cell/ml of Candida albican suspension was instilled or some cultured spores of Aspergillus funigatus or Fusarium solani were placed on the corneal surface. A soft contact lens was used to cover the cornea and tarsorrhaphy was performed. The infected corneas were examined by confocal mi- croscopy, smears and histopathological analysis at 5, 10, and 15 days postinoculation. Results In 1 - 5 days after infection,fungi- and acute inflammatory cells be seen in the anterior stroma. During 5-10 days,the host response suppressed fungal growth;by days 10-15,the infections were resolved. However, the diseased procession and the inflammatory reaction were severe in the Aspergillus and Fusarium than Candida infection. Budding yeast predominated after Candida infection and appeared as bright,hyper-reflective structures. Later,it became chain-like structures. Hyphae from Aspergillus appeared as slightly thicker, hyper-reflective branching structure compared with Candida. After mid stage,it became longer and less branch structures and stayed a longer time in corneal tissue than Candida. Hyphae of Fusarium appeared as worm-shape structures at the cornea surface at the early stage,became thicker stick-like structures with fewer branches. These results correlated with inspection of the smears and the histopathology study. Con- clusion The confocal microscopy provides valuable information in differentiation of fungal species in the living eye.
出处
《眼科研究》
CSCD
北大核心
2001年第5期389-392,共4页
Chinese Ophthalmic Research
