标题：5%那他霉素联合0.2%氟康唑治疗真菌性角膜炎65例疗效观察

      作者：龚 桦 1，龚向明 2，钟兴武 3
    (1.广州医学院荔湾医院眼科，广东 广州 510170；
2.广州中山大学中山眼科中心，广东 广州 510060；
3.中山大学中山眼科中心海南眼科医院，海南 海口 570311)

      卷次： 2013年24卷16期

      【摘要】 目的 观察联合应用5%那他霉素与0.2%氟康唑治疗真菌性角膜炎的疗效。方法 收集2010年1
月至2013年1月经角膜病灶取材直接湿片镜检或真菌培养阳性者共65例，根据角膜炎浸润的不同程度将病例
分为非严重的中轻度组与严重的重度组，联合应用5%那他霉素与0.2%氟康唑滴眼，每小时各一次，经规范治疗
7~10 d，视病情继续药物治疗或手术治疗，疗程共7~50 d不等。临床检查及疗效判断标准两组相同。结果 非严
重组24例，治愈23例（95.8%），1例有效（4.2%）；严重组41例，治愈12例（29.3%），有效11例（26.8%），无效18例
（43.9%）。两组间总的有效率差异具有显著统计学意义（P<0.01）。结论 5%那他霉素联合0.2%氟康唑治疗真
菌性角膜炎，特别是对非严重的中轻度者有非常满意的疗效，对严重的真菌性角膜炎也有较为满意的效果。

      【关键词】 真菌性角膜炎；那他霉素；氟康唑

      【中图分类号】 R722.21 【文献标识码】 A 【文章编号】 1003—6350（2013）16—2377—03


Combined use of 5% natamycin and 0.2% fluconazole for the treatment of fungal keratitis.
GONG Hua 1, GONG
Xiang-ming 2, ZHONG Xing-wu 3. 1. Depatment of Ophthamology, the Liwan Hospital of Guangzhou Medical College,
Guangzhou 510170, Guangdong, CHINA; 2. Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060,
Guangdong, CHINA; 3. Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou 570311,
Hainan, CHINA

【Abstract】 Objective To observe the clinical effects of combined use of 5% natamycin and 0.2% fluconazole for
the treatment of fungal keratitis. Methods Sixty-five patients with fungal keratitis were collected from Jan. 2010 to Jan.
2013 in the study. The patients were divided into the non-severe group and the severe group base on the degree of corneal
inflammation, which were treated with topical 5% natamycin and 0.2% fluconazole hourly, for 7~10 d. According to the
disease status, medication or surgery were applied, for 7~50 d. Clinical examination and clinical criteria were identical
in the two groups. Results Twenty-three (95.8%) of 24 patients with non-severe keratitis were healed, and 1 (4.2%)
showed effective response to treatment, while 12 (29.3%) of 41 patients with severe keratitis were healed, 11 (26.8%)
showed response to treatment, and 18 (43.9%) failed. The total effective rate showed statistically significant difference
between the two groups (P<0.01). Conclusion Combined use of 5% natamycin and 0.2% fluconazole for the treat-
ment of fungal keratitis has favorable effect, especially for the non-severe fungal keratitis.

      【Key words】 Fungal keratitis; Natamycin; Fluconazole