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中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2018, Vol. 08 ›› Issue (05) : 193 -201. doi: 10.3877/cma.j.issn.2095-2007.2018.05.001

所属专题： 文献；

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用好眼内液检测
刘瑄1, 陶勇2,†()   
  1. 1. 102218　清华大学附属北京清华长庚医院，清华大学临床医学院
    2. 100020　首都医科大学附属北京朝阳医院眼科
  • 收稿日期:2018-10-02 出版日期:2018-10-28
  • 通信作者: 陶勇
  • 基金资助:
    国家高技术研究发展计划(2015AA020949); 1351人才培养－朝阳新星计划(No. CYXX－2017－21)

Use the Examination of Intraocular Fluid Well

Xuan Liu1, Yong Tao2,†()   

  1. 1. Department of Ophthalmology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
    2. Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2018-10-02 Published:2018-10-28
  • Corresponding author: Yong Tao
  • About author:
    Corresponding author: Tao Yong, Email:
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引用本文：

刘瑄, 陶勇. 用好眼内液检测[J]. 中华眼科医学杂志(电子版), 2018, 08(05): 193-201.

Xuan Liu, Yong Tao. Use the Examination of Intraocular Fluid Well[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2018, 08(05): 193-201.

由于存在血眼屏障，眼内为独立的微环境。检查血清学指标，常常不能反映眼内的真实情况，甚至可能误导临床医生做出错误的判断。眼内液检测包括房水和玻璃体液在内的眼内液中病原微生物的核酸、抗体和细胞因子，可为临床提供眼内局部病原和免疫信息，有助于快速诊断。本文中笔者就眼内液检测的不同方面进行概述、总结和分析，为临床医生了解眼内液检测提供参考。

关键词: 房水, 玻璃体液, 眼内液检测, 诊断技术, 眼科

Due to the blood-ocular barrier, the intraocular microenvironment is independent. Traditional examinations of serum are often helpless and sometimes misleading. Examinations of intraocular fluids (aqueous humor and vitreous fluid) include pathogen deoxyribonucleic acid, antibodies and cytokines, which may help clinicians get in situ information and hereby confirm diagnosis rapidly. In the present paper, different aspects of examinations of intraocular fluid are summarized and analyzed, so as to provide a reference for clinicians to understand the examination of intraocular fluid.

Key words: Aqueous humor, Vitreous fluid, Examination of intraocular fluid, Diagnostic techniques, Ophthalmological
图1 眼内液检测常见的眼病眼底彩色图像及裂隙灯显微镜彩色图像　A图显示眼弓蛔虫病患者眼底彩色图像，可见累及黄斑区的脉络膜视网膜肉芽肿；B图显示眼弓蛔虫病患者眼底彩色图像，可见颞侧周边的脉络膜视网膜肉芽肿；图C　显示眼弓蛔虫病患者眼底彩色图像，可见视盘上方脉络膜视网膜炎性病灶；图D　显示眼弓形虫病患者眼底彩色图像，可见黄斑区脉络膜视网膜炎，玻璃体混浊；图E　显示真菌性眼内炎患者眼前节裂隙灯显微镜彩色图像，可见前房积脓；图F　显示真菌性眼内炎患者裂隙灯显微镜彩色图像，可见前部玻璃体白色混浊；图G　显示急性视网膜坏死患者眼底彩色图像，可见视盘下方脉络膜白色病灶，边界模糊，为内源性眼内炎来源；图H　显示急性视网膜坏死患者裂隙灯显微镜彩色图像，可见前部玻璃体混浊；图I　显示急性视网膜坏死患者眼底彩色图像，可见玻璃体混浊、视网膜动脉炎及视网膜坏死灶。
表1 不同地区作者报道检测急性视网膜坏死患者眼内液病毒的数据
作者 发表年限 总眼数 检测对象 检测阳性病例 阳性率 备注
Itoh等 2000 16 玻璃体液和房水 HSV－2阳性7眼 43.8% 作者同时检测了血清HSV－2抗体，发现仅在眼内液HSV－2阳性的患者中阳性
VZV阳性9眼 56.2%
Lau等 2007 18 玻璃体液 VZV阳性12眼 66.7% 所有EBV阳性的眼均为VZV阳性
HSV阳性4眼 22.2%
EBV阳性3眼 16.7%
Sugita等 2008 16 玻璃体液和房水 HSV－1阳性2眼 12.5% 结合了两种PCR方法进行检测
HSV－2阳性3眼 18.8%
VZV阳性11眼 68.8%
Hillenkamp等 2009 30 玻璃体液 VZV阳性26眼 86.7% VZV和EBV合并阳性2眼，VZV和HSV合并阳性1眼
HSV阳性5眼 16.7%
EBV阳性2眼 6.7%
Wong等 2010 81 玻璃体液 VZV阳性48眼 59.3% ?
? ? ? ? HSV阳性33眼 40.8% ?
Zhao等 2017 18 玻璃体液和房水 VZV阳性15眼 83.3% 采用xTAG液体芯片技术；5眼合并VZV和EBV阳性，1眼合并VZV、HSV－1、EBV阳性
HSV－1合并EBV阳性1眼 5.6%
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