【摘要】 目的　探讨棘阿米巴角膜炎的临床与实验室诊断方法 ,寻找有效滴眼液用以治疗。方法　观察分析 2 5例棘阿米巴角膜炎感染各阶段的临床表现 ,通过角膜细胞学检查、阿米巴分离培养、角膜活检及组织病理学检查确诊 ,检测药物对棘阿米巴的抗原虫作用及临床疗效。结果　感染自角膜上皮层开始 ,进行性侵入基质致盲。细胞学检查见包囊和 /或滋养体 (88 9% )。棘阿米巴培养阳性率 5 7 9%。洗必泰、甲硝唑滴眼液治疗棘阿米巴角膜炎有良效。抗原虫治疗2 4例 (2 5眼 ) ,治愈 2 1眼 ,无复发。结论　棘阿米巴角膜炎并非罕见 ,常因被误诊、误治导致视力丧失。重要的是早期诊断与抗原虫治疗。更多还原

【Abstract】 ObjectiveTo establish accurate means for clinical and laboratory diagnosis of acanthamoeba keratitis(AK)and to find effective eye drops for the treatment of AK.MethodsThe clinical manifestations at each of the stages of AK infection in 25 cases were investigated.Corneal cytology,isolation and cultivation of the amoeba,corneal biopsy and histopathological examination were applied to ascertain the diagnosis.Some chemicals were tested in vitro as well as in clinical trial to see whether they were effective in treating the infection.ResultsThis series consisted of 25 cases (26 eyes),of which 8 eyes(30 8%) were related to wearing soft contact lens.The infection started from corneal epithelial layer and then spread progressively,slowly to the stroma to cause severe corneal inflammation and finally causing loss of vision.Corneal scrapings demonstrated the presence of cyst and/or trophozoite in 16(88 9%) out of 18 infected eyes.Isolations of acanthamoeba were recovered from 57 9% of corneal specimens.Chlorhexidine and metronidazole eye drops were found to be effective both in vitro and in clinical trials.Out of the treated 24 cases (25 infected eyes),21 eyes were completely cured without recurrence.ConclusionAt this site,AK is not a very rare infectious corneal disease.It is often been misdiagnosed and improperly treated.Early diagnosis and antiprotozoal therapy is important to control this infection and preserve sight.更多还原