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[棘阿米巴角膜炎角膜涂片的形态学特征]

[Morphological characteristics in corneal smear of acanthamoeba keratitis].

作者信息

Wang Zhi-qun, Li Ran, Zhang Chen, Luo Shi-yun, Sun Xu-guang, Jin Xiu-ying

机构信息

Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2010 May;46(5):432-6.

Abstract

OBJECTIVE

To study the morphological characteristics in corneal smear of acanthamoeba keratitis.

METHODS

Experimental study. From May 1991 to December 2007, in Department of Microbiology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, 159 cases with acanthamoeba keratitis were analyzed for the laboratory results and clinical data. Giemsa's stained smear and wet-mount preparation of 159 cases were observed, all the results of cytology be photographed as the records.

RESULTS

Among the 159 cases with acanthamoeba keratitis, 131 patients (82.4%) were positive on smear, and 110 cases (69.2%) were positive in culture of amoeba. The detection positive rate of smear was apparently higher than culture. Typical trophozoites, pre-encystment trophozoites, mature cysts and empty cysts could be observed by smear. So it is an important method for the clinical diagnosis. The edema and dissolved corneal epithelial cells, exudate cells, arthrospores or chlamydoconidium of mycelial fungus, vacuoles, lipid droplet and medicine crystallization should be differentiated with the pathogen. The movement of trophozoites could mainly be observed through wet-mount preparation.

CONCLUSION

The detection of typical features of trophozoites, pre-encystment trophozoites, mature cysts and empty cysts by corneal smear is important for the etiological diagnosis of acanthamoeba keratitis.

摘要

目的

研究棘阿米巴角膜炎角膜涂片的形态学特征。

方法

实验研究。1991年5月至2007年12月,在北京同仁医院北京眼科研究所微生物科,对159例棘阿米巴角膜炎患者的实验室检查结果和临床资料进行分析。观察159例患者的吉姆萨染色涂片及湿片标本,将所有细胞学结果拍照记录。

结果

159例棘阿米巴角膜炎患者中,涂片阳性131例(82.4%),阿米巴培养阳性110例(69.2%)。涂片检测阳性率明显高于培养。涂片可观察到典型滋养体、包囊前期滋养体、成熟包囊和空包囊。因此,这是临床诊断的重要方法。需将角膜上皮细胞水肿溶解、渗出细胞、丝状真菌的关节孢子或厚壁孢子、空泡、脂滴和药物结晶与病原体相鉴别。滋养体的运动主要通过湿片标本观察。

结论

角膜涂片检测到典型的滋养体、包囊前期滋养体、成熟包囊和空包囊特征对棘阿米巴角膜炎的病因诊断具有重要意义。

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