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浙江大学学报（医学版）
浙江大学学报（医学版）  2020, Vol. 49 Issue (5): 644-650    DOI: 10.3785/j.issn.1008-9292.2020.07.03
综述     
病毒感染性眼病病原学诊断的研究进展
段润平(),许叶圣,郑利斌,姚玉峰*()
浙江大学医学院附属邵逸夫医院眼科, 浙江 杭州 310016
Research progress on etiologic diagnosis of ocular viral diseases
DUAN Runping(),XU Yesheng,ZHENG Libin,YAO Yufeng*()
Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
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摘要：

多种病毒可导致眼部疾病，包括腺病毒、人类疱疹病毒、人类T淋巴细胞白血病病毒1型（HTLV-1）及新发现的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）等。这类疾病的鉴别诊断较困难，容易被误诊和漏诊，导致严重的组织损伤和视觉损伤。腺病毒、单纯疱疹病毒1型和水痘-带状疱疹病毒相关眼病的诊断中，病原学诊断可作为一种强有力的辅助诊断工具；而在单纯疱疹病毒2型、巨细胞病毒、EB病毒、人类疱疹病毒6型和7型、人类疱疹病毒8型、HTLV-1和SARS-CoV-2相关眼病的诊断中，病原学诊断则发挥着主导作用。病毒培养、免疫组织化学或免疫荧光法及以PCR为代表的病毒基因诊断法是三种主要的病原检测手段，其中PCR技术检测快速、操作便捷、敏感度和特异度高，成为眼科病毒学诊断中最重要的工具。
关键词： 病毒性疾病;  眼部疾病;  流行病学;  病原学诊断;  聚合酶链反应;  综述    
Abstract:

A large number of viruses have been found to be associated with ocular diseases, including human adenovirus, human herpesvirus (HHV), human T lymphotropic virus type-1 (HTLV-1), and newly emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This group of diseases is prone to be misdiagnosed or missed diagnosis, resulting in serious tissue and visual damage. Etiological diagnosis is a powerful auxiliary mean to diagnose the ocular diseases associated with human adenovirus, herpes simplex virus 1 and varicella-zoster virus, and it provides the leading diagnosis evidence of infections with herpes simplex virus 2, Epstein-Barr virus, cytomegalovirus, HHV-6/7, HHV-8, HTLV-1 and SARS-CoV-2. Virus isolation, immunoassay and genetic diagnosis are usually used for etiologic diagnosis. For genetic diagnosis, the PCR technique is the most important approach because of its advantages of rapid detection, convenient operation, high sensitivity and high specificity.
Key words: Viral diseases    Ocular diseases    Epidemiology    Etiologic diagnosis    Polymerase chain reaction    Review
收稿日期: 2020-02-03 出版日期: 2020-11-19
:  R77  
基金资助: 浙江省重点研发计划(2018C03082)
通讯作者: 姚玉峰     E-mail: ophthaldrp@zju.edu.cn;yaoyf@zju.edu.cn
作者简介: 段润平(1995-), 男, 硕士, 住院医师, 主要从事病毒感染性眼病快速病原诊断研究; E-mail:ophthaldrp@zju.edu.cn; https://orcid.org/0000-0003-3679-1660
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引用本文:

段润平,许叶圣,郑利斌,姚玉峰. 病毒感染性眼病病原学诊断的研究进展[J]. 浙江大学学报（医学版）, 2020, 49(5): 644-650.

DUAN Runping,XU Yesheng,ZHENG Libin,YAO Yufeng. Research progress on etiologic diagnosis of ocular viral diseases. J Zhejiang Univ (Med Sci), 2020, 49(5): 644-650.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.07.03    或    http://www.zjujournals.com/med/CN/Y2020/V49/I5/644

病毒名称 眼部疾病 病原学诊断方法 参考文献序号
腺病毒 角结膜炎、咽结膜热 病毒分离培养、免疫荧光、PCR 12
人类疱疹病毒
  单纯疱疹病毒1型 角膜炎、葡萄膜炎、视网膜炎 病毒分离培养、免疫荧光、PCR 4, 26
  单纯疱疹病毒2型 急性视网膜坏死、葡萄膜炎 PCR 29-30
  水痘-带状疱疹病毒 角膜炎、葡萄膜炎、急性视网膜坏死 病毒分离培养、PCR 20
  EB病毒 结膜良性肿瘤、葡萄膜炎、视网膜炎 PCR 31, 39
  巨细胞病毒 视网膜炎、角膜内皮炎、葡萄膜炎 PCR 6, 22, 28
  人类疱疹病毒6型 角膜炎、葡萄膜炎 PCR 32, 40
  人类疱疹病毒7型 角膜内皮炎、眼部附属器淋巴瘤 PCR 41-42
  人类疱疹病毒8型 结膜卡波西肉瘤、葡萄膜炎 PCR 33, 43
人类T淋巴细胞白血病病毒1型 葡萄膜炎、角结膜干燥征、角膜炎 PCR 5
严重急性呼吸综合征冠状病毒2 结膜炎 PCR 8
表 1  11种病毒的相关眼部疾病及其病原学诊断方法
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