摘要目的 探讨2％汞溴红染色镜检在真菌性角膜炎诊断中的应用.方法 临床病例系列研究.对2009年1月至2013年12月在福建中医药大学附属人民医院眼科临床诊断为真菌性角膜炎127例行角膜刮片,标本分别行2％汞溴红水溶液染色、KOH湿片检查和真菌培养及菌种鉴定.以培养结果做为确诊真菌性角膜炎的“金标准”.结果 127例真菌性角膜炎病例中93例检出真菌,阳性率73.23％(93/127).2％汞溴红水溶液染色光镜检查或荧光显微镜检查找真菌的灵敏度、特异度、阳性率、正确指数、阳性预测值、阴性预测值均高于KOH湿片法;2％汞溴红水溶液染色法查找真菌的假阳性率、假阴性率均低于KOH湿片法.2％汞溴红水溶液染色光镜检查与2％汞溴红水溶液染色荧光显微镜检查串联试验提高了诊断试验的特异度和阳性预测值,但降低了诊断试验的检出率、灵敏度、假阳性率和阴性预测值.2％汞溴红水溶液染色光镜检查与2％汞溴红水溶液染色荧光显微镜检查并联试验提高诊断试验检出率、灵敏度、假阳性率和阴性预测值,但降低了诊断试验的假阴性率和阳性预测值.结论 2％汞溴红水染色镜检法是真菌性角膜炎早期诊断的快速、有效方法.

abstractsObjective To evaluate the application of 2％ mercurochrome solution staining in the diagnosis of fungal keratitis.Methods A total of 127 fungal keratitis cases were collected from January 2009 to December 2013.The corneal scraping specimens were performed 2％ mercurochrome solution staining and 10％ KOH based smear before microscopic observation,fungal culture and strain identification.Results Among 127 samples of fungal keratitis,93 cases were positive.The positive rate was 73.23％.The sensitivity,specificity,positive rate,correct index,positive predictive value and negative predictive value of 2％ mercurochrome solution staining observed by optical microscope and fluorescence microscope were larger than those of KOH based smear.2％ mercurochrome solution staining observed by optical microscope and mercurochrome solution staining observed by fluorescence microscope serial test increased the specificity and positive predictive value of diagnostic tests,but decreased the positive rate,sensitivity,false positive rate and negative predictive value of diagnostic tests.2％ mercurochrome solution staining observed by optical microscope and mercurochrome solution staining observed by fluorescence microscope parallel test increased the positive rate,sensitivity,false positive rate and negative predictive value of diagnostic tests,but decreased the false negative rate and positive predictive value of diagnostic tests.Conclusions 2％ mercurochrome solution staining is a fast,effective way for the early diagnosis of fungal keratitis.