氯霉素滴眼液初始治疗铜绿假单胞菌性角膜炎对其预后的影响

doi:10. 3969 / j. issn. 2096-2266. 2021. 08. 019

大理大学学报 ›› 2021, Vol. 6 ›› Issue (8): 81-84.DOI: 10. 3969 / j. issn. 2096-2266. 2021. 08. 019

氯霉素滴眼液初始治疗铜绿假单胞菌性角膜炎对其预后的影响

莫逆1，郑志梅2，李廷娜1，李桂香1，俞德顺3*

（1. 大理白族自治州人民医院眼科，云南大理 671000；2. 宾川县人民医院眼科，云南宾川 671600；
3. 大理大学第一附属医院耳鼻咽喉科，云南大理 671000）

收稿日期:2020-08-13 修回日期:2021-03-19 出版日期:2021-08-15 发布日期:2021-09-29
通讯作者: 俞德顺，主治医师，E-mail：1667991742@qq.com。
作者简介:莫逆，主治医师，主要从事眼科学研究。

Initial Treatment of Pseudomonas aeruginosa Keratitis with Topical Chloramphenicol and Effects#br# on Prognosis

Mo Ni1, Zheng Zhimei2, Li Tingna1, Li Guixiang1, Yu Deshun3*

(1. Department of Ophthalmology, Dali Bai Autonomous Prefecture People s Hospital, Dali, Yunnan 671000, China; 2. Department of
Ophthalmology, Binchuan People s Hospital, Binchuan, Yunnan 671600, China; 3. Department of Otolaryngology, The First
Affiliated Hospital of Dali University, Dali, Yunnan 671000, China)

Received:2020-08-13 Revised:2021-03-19 Online:2021-08-15 Published:2021-09-29

摘要/Abstract

摘要： 目的：确定初始使用氯霉素经验性治疗铜绿假单胞菌性角膜炎是否对其预后产生积极作用。方法：回顾性分析 2014 年
1 月至 2019 年 12 月大理白族自治州人民医院眼科细菌培养和鉴定为铜绿假单胞菌性角膜炎患者77 例（77 眼）。根据使用左
氧氟沙星滴眼液前是否使用氯霉素滴眼液情况，分为氯霉素组和非氯霉素组，并记录开始使用左氧氟沙星滴眼液时患眼的溃疡
面积、初始最佳矫正视力、最终最佳矫正视力，病程及并发症。结果：36.36% 的患者在使用左氧氟沙星滴患眼前使用了氯霉
素滴眼液，氯霉素组的溃疡面积更大（P < 0.05），两组的初始最佳矫正视力和最终最佳矫正视力比较差异无统计学意义，氯
霉素组的病程更长（P < 0.05），氯霉素组和非氯霉素组出现角膜血管翳和角膜穿孔的比率分别为3.57% 和 2.04%，差异无统计
学意义（P > 0.05）。溃疡面积与初始最佳矫正视力无相关性（r < 0.2），病程长短与溃疡面积、初始最佳矫正视力及最终最佳
矫正视力有一定相关性（0.2 < r < 0.4）。最终最佳矫正视力与初始最佳矫正视力有较强的相关性（r > 0.6）。结论：超过 1/3 的
铜绿假单胞菌性角膜炎患者在使用左氧氟沙星滴眼液前使用了氯霉素滴眼液，使用氯霉素滴眼液并不提高患者的最终最佳矫正
视力、缩短病程和减少并发症的发生。

关键词: 角膜炎, 铜绿假单胞菌性角膜炎, 氯霉素滴眼液, 左氧氟沙星滴眼液

Abstract: Objective: To determine whether the initial use of chloramphenicol for empirical treatment of Pseudomonas aeruginosa
keratitis has a positive effect on its prognosis. Methods: 77 patients (77 eyes) from January 2014 to December 2019, bacterial cultured
and identified as bacterial infection by Pseudomonas aeruginosa in the ophthalmology department of Dali Bai Autonomous Prefecture
People s Hospital were retrospectively analyzed. According to the use of chloramphenicol eye drops before levofloxacin eye drops,
they were divided into chloramphenicol group and non-chloramphenicol group. The ulcer area, the initial best corrected visual acuity, the
final best corrected visual acuity, the course of the disease and the complications when starting to use levofloxacin eye drops were
recorded in details. Results: 36.36% of patients used chloramphenicol eye drops before levofloxacin drops. The ulcer area in the
chloramphenicol group was larger (P<0.05), and the initial best corrected visual acuity and final best corrected visual acuity of the two
groups had no statistically significant difference. The course of the disease was longer in the chloramphenicol group (P<0.05). The
rates of corneal pannus and corneal perforation in the chloramphenicol group and non-chloramphenicol group were 3.57% and 2.04%,
respectively (P>0.05). There was no correlation between the area of the ulcer and the initial best corrected visual acuity (r <0.2). The
length of the disease has a certain correlation with the area of the ulcer, the initial best corrected visual acuity and the final best
corrected visual acuity (0.2 <r <0.4). The final best corrected visual acuity has a strong correlation with the initial best corrected visual
acuity (r> 0.6). Conclusion: More than 1/3 Pseudomonas aeruginosa keratitis patients used chloramphenicol eye drops before using
levofloxacin eye drops, but using chloramphenicol eye drops did not improve the patient s ultimate corrective vision, shorten course, or
reduce the incidence of complications.

Key words: keratitis, Pseudomonas aeruginosa keratitis, chloramphenicol eye drops, levofloxacin eye drops

中图分类号:

莫逆, 郑志梅, 李廷娜, 李桂香, 俞德顺. 氯霉素滴眼液初始治疗铜绿假单胞菌性角膜炎对其预后的影响[J]. 大理大学学报, 2021, 6(8): 81-84.

Mo Ni, Zheng Zhimei, Li Tingna, Li Guixiang, Yu Deshun. Initial Treatment of Pseudomonas aeruginosa Keratitis with Topical Chloramphenicol and Effects#br# on Prognosis[J]. Journal of Dali University, 2021, 6(8): 81-84.

0
/ / 推荐

导出引用管理器 EndNote|Ris|BibTeX

链接本文: http://journal15.magtechjournal.com/Jwk_dlxyzk/CN/10. 3969 / j. issn. 2096-2266. 2021. 08. 019

http://journal15.magtechjournal.com/Jwk_dlxyzk/CN/Y2021/V6/I8/81

参考文献

〔1〕WHITCHER J P, SRINIVASAN M, UPADHYAY M
P. Corneal Blindness: A Global Perspective〔J〕. Bull
World Heal Organ, 2001, 79(3): 214-221.
〔2〕PASCOLINI D, MARIOTTI S P. Global Estimates of
Visual Impairment: 2010〔J〕. Br J Ophthalmol, 2012,
96(5): 614-618.
〔3〕GUPTA N, TANDON R, GUPTA S K, et al. Burden of
Corneal Blindness in India〔J〕. Indian J Community
Med, 2013, 38(4): 198-206.
〔4〕UBANI-UKOMA U, GIBSON D, SCHULTZ G, et al.
Evaluating the Potential of Drug Eluting Contact Lenses
for Treatment of Bacterial Keratitis Using an ex vivo
Corneal Model〔J〕. Int J Pharm, 2019, 565(3): 499-
508.
〔5〕BOGRAD A, SEILER T, DROZ S, et al. Bacterial and
Fungal Keratitis: A Retrospective Analysis at a University
Hospital in Switzerland〔J〕. Klinische Monatsblatter

Fur Augenheilkunde, 2019, 236(4): 358-365.

〔6〕GREEN M, APEL A, STAPLETON F. Risk Factors
and Causative Organisms in Microbial Keratitis〔J〕.
Cornea, 2008, 27(1): 22-27.
〔7〕KEAY L, STAPLETON F, SCHEIN O. Epidemiology
of Contact Lens-Related Inflammation and Microbial
Keratitis: A 20-Year Perspective〔J〕. Eye Contact
Lens, 2007, 33(6): 346-353.
〔8〕钟文贤, 孙士营, 赵靖, 等. 1 054 例化脓性角膜炎的回
顾性分析〔J〕. 中华眼科杂志, 2007, 43(3): 245-250.
〔9〕SAND D, SHE R, SHULMAN I A, et al. Microbial
Keratitis in Los Angeles: The Doheny Eye Institute and
the Los Angeles County Hospital Experience〔J〕.
Ophthalmology, 2015, 122(5): 918-924.
〔10〕AUSTIN A, LIETMAN T, ROSE-NUSSBAUMER J.
Update on the Management of Infectious Keratitis〔J〕.
Ophthalmology, 2017, 124(11): 1678-1689.
〔11〕RACHWALIK D, PLEYER U. Bakterielle Keratitis 〔J〕.
Klin Monbl Augenheilkd, 2015, 232(6): 738-744.
〔12〕王智群, 张阳, 孙旭光. 2007—2013 年眼部细菌培养
阳性菌株的分布及其耐药性分析〔J〕. 眼科, 2015,
24(4): 262-267.
〔13〕JENG B H, GRITZ D C, KUMAR A B, et al. Epidemiology
of Ulcerative Keratitis in Northern California〔J〕.
Arch Ophthalmol, 2010, 128(8): 1022-1028.
〔14〕TUFT S J, MATHESON M. In vitro Antibiotic Resistance
in Bacterial Keratitis in London〔J〕. Br J Ophthalmol,
2000, 84(7): 687-691.
〔15〕ORLANS H O, HORNBY S J, BOWLER I C. In vitro
Antibiotic Susceptibility Patterns of Bacterial Keratitis
Isolates in Oxford, UK: A 10-Year Review〔J〕. Eye
(Lond), 2011, 25(4): 489-493.
〔16〕PEARCE F, WONG N, CHAN E. Incidence of
Chloramphenicol Use and the Effect on Corneal
Scrape Results in Bacterial Keratitis〔J〕. Clin Exp
Ophthalmol, 2016, 44(9): 868-869.
〔17〕BOURKIZA R, KAYE S, BUNCE C, et al. Initial
Treatment of Pseudomonas aeruginosa Contact Lens-
Associated Keratitis with Topical Chloramphenicol,
and Effect on Outcome〔J〕. Br J Ophthalmol, 2013,
97(4): 429-432.

氯霉素滴眼液初始治疗铜绿假单胞菌性角膜炎对其预后的影响

Initial Treatment of Pseudomonas aeruginosa Keratitis with Topical Chloramphenicol and Effects#br# on Prognosis

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

编辑推荐

Metrics

本文评价