目的 对真菌性角膜炎的流行病学特征和常见致病原因进行分析,为临床早期诊断和防治提供依据.方法 对2008年1月～ 2010年12月收治的278例真菌性角膜炎患者的性别、季节性特征、致病原因及角膜刮片、真菌培养结果进行回顾性分析.结果 278例真菌性角膜炎患者中男172例(61.9％),女106例(38.1％);146例(52.5％)发病集中在9～11月;有明确致病原因144例,其中植物性外伤65例(23.4％)、异物外伤51例(18.3％);251例(90.3％)角膜刮片检查发现真菌菌丝或孢子;225例真菌培养分离出真菌197株(87.6％),其中镰刀菌属131例(66.5％)、链格孢属41例(20.8％)、曲霉菌属12例(6.1％)、酵母菌属4例(2.0％)、毛霉菌属3例(1.5％)、其他菌属6例(3.0％).结论 本地区真菌性角膜炎的发病呈显著季节性,植物性外伤和异物损伤是主要致病原因,镰刀菌属是最为常见的病原菌;角膜溃疡组织刮片直接显微镜检查是早期确诊的有效方法.%Objective To analyze the epidemiologic feature and common cause of fungal keratitis, so to provide evidence for the prevention and treatment of fungal keratitis. Methods The patients'sex, seasonal characteristics, the results of cornea smears and fungal culture between January 2008 and December 2010 were analyzed retrospectively. Results A total of 278 fungal keratitis cases were investigated in this study, which included 172 (61.9% ) male and 106 (38. 1% ) female patients; The onset of the disease was mainly from September to November, which accounted for 52. 5% of total patients; 144 patients have determined etiology for ocular infection, among whom 65 (23.4% ) had injury history related to plant hindings and 51 ( 18. 3% ) had injury history related to eyewinker removal; The positive rate was 90. 3% (251/278) by microscopic analysis of KOH wet mounts; The number of positive culture was 197, in which the main fungal isolates were Fusarium species 131cases (66. 5% ) and Alternaria species 41cases (20. 8% ) , Aspergillus 12 cases (6. 1% ) , Saccharomycetes 4 cases(2. 0% ) , Mucor 3 cases( 1. 5% ) , others 6 cases(3. 0% ) . Conclusions The incidence of fungal keratitis shows seasonal characteristics, and is closely related to injury history related to plant hindings and injury history related to eyewinker removal, the Fusarium species is the predominant pathogen of fungal keratitis; Corneal ulcer tissue examination under microscope fluorescent is the most effective method for early diagnosis.
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