目的:分析长江中下游地区真菌性角膜炎流行病学特征及治疗预后状况。方法:对2004-01/2009-12我院212例212眼确诊为真菌性角膜炎患者的完整资料进行回顾性分析,调查内容包括职业、发病时间、发病原因、就诊经过、治疗情况及转归等。结果:患者中男159例,女53例,平均年龄44.5岁。职业为农民者177例(83.5%)。98例(46.2%)患者有明确植物性外伤史或接触史。发病时间在10～12月份者136例(64.2%)。从发病到我院平均就诊时间为24.1d。就诊时视力<0.05者158眼(74.5%)。眼部标本真菌培养阳性者194例(91.5%),主要致病菌属为镰刀菌属144株(74.2%),其次为曲霉菌属16株(8.3%),暗色孢科真菌共32株(15.1%),念珠菌属2株(1.0%)。117例(55.2%)患者经药物治疗好转;59例(27.8%)患者行角膜移植术,植片透明率64.4%;20例(9.4%)行球结膜瓣遮盖术治愈。随访6～25mo,最终视力<0.05者63眼(29.7%);眼球保存率96.6%。结论:长江中下游地区真菌性角膜炎高发季节为10～12月份,高发人群为中青年农民,主要致病菌属为镰刀菌属,积极的药物和手术治疗是挽救眼球、保存视力的有效手段。

AIM:To determine the epidemiological features of fungal keratitis in middle and lower reaches of Yangtze river. METHODS:Two hundred and twelve fungal keratitis cases were evaluated and demographic data were recorded,including age,gender,occupation,whether or not they have a history of trauma or contact lens use and course of treatment. RESULTS:The cases of fungal keratitis were increased year after year.159 patients were male,177(83.5%) were agriculture worker,the mean age was 44.5 years old,a history of trauma was present in 98 patients(46.2%).The interval between infection and presentation for examination was 3-160 days,with a mean time of 24.1 days.117(55.2%) cases were healed after medical treatment.59(27.8%)cases received keratoplasty,with a clear graft rate of 64.4%.The most common spectrums were Fusarium sp.(74.2%) and Aspergillus sp.(8.3%). CONCLUSION:In Hubei,the most common pathogenic spectrum of fungal keratitis is Fusarium sp.Fungal keratitis is a grave disease that causes blindness.It is significantly important to improve the diagnosis level and give perfect treatment.

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