A 5-Year Retrospective Analysis of the Risk Factors, Treatment, and Prognosis of Patients With Fungal Keratitis in Heilongjiang, China
A 5-Year Retrospective Analysis of the Risk Factors, Treatment, and Prognosis of Patients With Fungal Keratitis in Heilongjiang, China
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DOI：
10.1016/j.ajo.2022.07.023
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发表时间：
2022-09-16
影响因子：
4.2
通讯作者：
Zhang, Hong
中科院分区：
文献类型：
--
作者：
Jin, Xin;Feng, Jiaoyang;Zhang, Hong
目的：报告中国黑龙江省农忙期间（5月、6月、9月至11月）真菌性角膜炎（FK）患者的流行病学特征、实验室检查结果和治疗结果。设计：回顾性、观察性案例系列。方法：收集2017年至2021年哈尔滨医科大学附属第一医院眼科医院诊断为FK的患者251例。回顾性分析病历，收集人口特征、危险因素、每月分布、临床特征、实验室检查结果、治疗策略和预后数据。结果：农忙期FK病例数占总数的74.1%（186/251）。患者平均年龄为 58.2 +/- 9.5 岁。男性（66.7%）比女性（33.3%）更容易发生 FK，其中 80.1%（149/186）的病例中植物相关创伤是主要原因。最常见的致病真菌是镰刀菌（34.9%）。体内共聚焦显微镜对FK诊断的阳性率最高（94.6%）。前房积脓的深度、菌丝或孢子的深度以及浸润宽度与迟发呈显着正相关。结论：入院时间较长的患者更有可能因局部药物治疗失败而接受手术。预防FK最重要的措施是在户外作业时使用眼睛防护装置，眼睛受伤后尽快去医院治疗。 （(C) 2022 作者。由 Elsevier Inc. 出版）
PURPOSE: To report the epidemiologic features, laboratory findings, and treatment outcomes of patients with fungal keratitis (FK) during a busy farming period (May, June, and September to November) in Heilongjiang Province, China. DESIGN: Retrospective, observational case series. METHODS: In total, 251 patients diagnosed with FK at the Eye Hospital, First Affiliated Hospital of Harbin Medical University, from 2017 to 2021 were identified. Medical records were retrospectively analyzed, and demographic features, risk factors, monthly distributions, clinical characteristics, laboratory findings, treatment strategies, and prognostic data were collected. RESULTS: The number of FK cases in the busy farming period accounted for 74.1% (186/251) of the total. The mean patient age was 58.2 +/- 9.5 years. Males (66.7%) were more likely to develop FK than females (33.3%), and plant-related trauma was the main cause in 80.1% (149/186) of the cases. The most common causative fungal species was Fusarium (34.9%). In vivo confocal microscopy had the highest positivity rate for FK diagnosis (94.6%). The depth of hypopyon, depth of hyphae or spores, and infiltrate width were significantly positively correlated with delayed presentation. CONCLUSIONS: Patients with a longer time of presentation to the hospital were more likely to undergo surgery because of topical medical therapy failure. The most important measures for FK prevention are the use of eye protection during outdoor work and visiting the hospital for treatment as soon as possible after eye injury. ((C) 2022 The Authors. Published by Elsevier Inc.)