苏木素在真菌性角膜炎诊断中的应用(1)
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【摘要】 目的 研究苏木素在真菌性角膜炎早期诊断中的价值。 方法 2006年6月至2011年6月期间临床诊断为真菌性角膜炎病例59例，角膜刮片，标本分别行苏木素染色、KOH湿片检查和真菌培养。以培养结果做为确诊真菌性角膜炎的“金标准”。 结果 59例真菌性角膜炎病例中47例检出真菌，阳性率79.66%。苏木素染色法查找真菌阳性率64.40%，灵敏度74.46%，特异度42.86%，假阳性率25.00%，假阴性率25.53%，正确指数17.32%，阳性预测值92.11%，阴性预测值42.85%。KOH湿片法查找真菌阳性率45.76%，灵敏度44.68%，特异度18.75%，假阳性率50.00%，假阴性率55.32%，正确指数-36.57%，阳性预测值77.78%，阴性预测值18.75%。结论 苏木素染色法是真菌性角膜炎早期诊断的快速、有效方法。
【关键词】 真菌性角膜炎；苏木素；KOH湿片法；培养
Application of hematoxylin staining in fungal keratitis
WU Sheng-ge.
Minnan Sorting of The First Affiliated Hospital of Fujian Medical University,Quanzhou 362800,China
【Abstract】 Objective To investigate the application of hematoxylin staining in the diagnosis of fungal keratitis. Methods 59 fungal keratitis cases were collected from June 2006 to June 2011. The corneal scraping specimens were performed hematoxylin staining and 10% KOH based smear before microscopic observation and fungal culture. Results 47 cases were positive among 59 samples of fungal keratitis, the positive rate was 79.66%. Hematoxylin staining showed the positive rate was 64.40%, sensitivity was74.46%, specificity42.86%, false positive rate was 25.00%, false negative rate was 25.53%, the correct index was 17.32%, positive predictive value was 92.11%, negative predictive value was 42.85%.10% KOH based smear showed the positive rate was 45.76%, sensitivity was 44.68%, specificity was 18.75%, false positive rate was 50.00%, false negative rate was 55.32%, the correct index was 36.57%, positive predictive value was 77.78%, negative predictive value was 18.75%. Conclusion Hematoxylin staining is a fast, effective way for the early diagnosis of fungal keratitis.
【Key words】 Fungal keratitis;Hematoxylin staining; KOH based smear; Culture
真菌性角膜炎是我国常见的致盲眼病。近年来，真菌性角膜炎发病率不断上升，部分地区成为首位感染性眼病[1-3]。真菌性角膜炎的确诊一般依靠涂片细胞学和真菌培养为主[4]。真菌培养是真菌性角膜炎诊断的“金标准”[4-5]，但真菌培养时间长，等待结果往往延误治疗[5]。传统KOH湿片法检查真菌性角膜炎的诊断阳性率低，误诊率高。如何快速准确地诊断真菌性角膜病是目前研究的热点[4]。本研究收集2006年6月至2011年6月期间临床诊断为真菌性角膜炎病例59例，研究苏木素在真菌性角膜炎早期诊断中的应用价值。
1 资料与方法
1.1 一般资料
我院2006年6月至2011年6月期间临床诊断为真菌性角膜炎病例，59例患者中男36例，女23例；右眼31例，左眼28例；年龄15~67岁,平均49.3岁；农民38例，工人13例，其他8例；眼外伤史51例 ......
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