【摘要】 目的 探究不同病原菌属与真菌性角膜炎(FK)患者预后的关系。方法 选取2018年1月—2019年12月收治的120例(120只眼)FK,根据感染病原菌属分为A组(病原菌属为链格孢属)20例、B组(病原菌属为曲霉菌属)28例、C组(病原菌属为镰刀菌属)57例和D组(病原菌属为其他菌属)15例。分析FK患者病原菌属分布情况及主要病原菌属药物的耐药率，探讨不同病原菌属与FK患者预后的关系，并比较4组药物治愈患者用药时间和停药后4周患眼最佳矫正视力。结果 120例FK共培养出127株真菌，其中镰刀菌属最多占44.88%,其次为曲霉菌属(25.98%)、链格孢属(15.75%)。链格孢属、曲霉菌属、镰刀菌属对氟康唑和伊曲康唑的耐药率均较高，对那他霉素和两性霉素B的耐药率均较低。B、C组预后水平较A、D组差(P<0.05),B、C组之间和A、D组之间预后水平比较差异无统计学意义(P>0.05)。药物治愈患者用药时间C组明显长于A、B、D组(P<0.05);药物治愈患者停药后4周患眼最佳矫正视力A组高于B、C、D组(P<0.05)。结论 FK患者多为链格孢属、曲霉菌属、镰刀菌属感染，根据药物敏感试验结果推荐采用那他霉素、两性霉素B治疗，而曲霉菌属、镰刀菌属感染FK患者预后较差。更多还原

【Abstract】 Objective To explore the relationship between different pathogenic bacteria and the prognosis of patients with fungal keratitis(FK). Methods A total of 120 cases of FK(120 eyes) admitted from January 2018 to December 2019 were selected and divided into group A(Alternaria spp, n=20), group B(Aspergillus, n=28), group C(Fusarium, n=57), and group D(other genus, n=15) according to the genus of pathogenic bacteria. The distribution of pathogenic bacteria in patients with FK and the drug resistance rate of major pathogenic bacteria were analyzed, and the relationship between different pathogenic bacteria and the prognosis of patients with FK was investigated. The duration of drug treatment and the best corrected visual acuity(BCVA) of the affected eye at 4 weeks after drug withdrawal were compared in each group. Results In total, 127 fungal strains were co-cultured from 120 FK cases, of which Fusarium was the highest, accounting for 44.88%, followed by Aspergillus(25.98%) and Alternaria(15.75%). Alternaria, Aspergillus, and Fusarium were all highly resistant to Fluconazole and Itraconazole, and were less resistant to Natamycin and Amphotericin B. The prognosis of groups B and C was worse than that of groups A and D(P<0.05). There was no significant difference in the prognosis between groups B and C and between groups A and D(P>0.05). The duration of drug use of the cured patients in group C was significantly longer than that in groups A, B, and D(P<0.05). The BCVA of the affected eyes of the cured patients in group A was higher than that in groups B, C, and D at 4 weeks after drug withdrawal(P<0.05). Conclusion FK patients are mostly infected by Alternaria, Aspergillus and Fusarium. Natamycin and Amphotericin B are recommended according to the drug sensitivity test results, while the prognosis of FK patients with Aspergillus and Fusarium infection is poor.更多还原