【作者】 王英明；

【导师】 张晓峰；

【作者基本信息】 苏州大学 ， 眼科学， 2013， 硕士

【摘要】 目的研究氟硅丙烯酸酯系列（XO, EO）和聚甲基丙烯酸甲酯（PMMA）等三种硬性角膜接触镜材料镜片表面金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞杆菌的粘附数量。方法分别将三种硬性角膜接触镜材料镜片置于三种细菌悬液中培养，采用MTT比色法、旋涡震荡-菌落计数法和扫描电子显微镜观察研究材料表面细菌粘附。结果MTT比色法：XO材料表面金黄色葡萄球菌中粘附量明显少于EO和PMMA材料（q=7.379, q=8.207, P<0.01），EO与PMMA材料差异无统计学意义（q=0.828,P>0.05）；XO、EO材料表面表皮葡萄球菌粘附量均少于PMMA材料（q=14，q=12.8,P<0.01），XO和EO材料差异无统计学意义（q=1.2, P>0.05）；三种材料表面铜绿假单胞杆菌粘附量差异无统计学意义（F=2.155, P>0.05）。旋涡震荡-菌落计数法，XO、EO、PMMA材料表面金黄色葡萄球菌粘附量依次增多（q=11.65, q=28.64，q=16.99,P<0.01）；XO材料表面表皮葡萄球菌粘附量明显少于PMMA材料（q=5.06, P<0.05），XO和EO材料、EO和PMMA材料之间差异无统计学意义（q=3.29, q=1.77, P>0.05）；三种材料表面铜绿假单胞杆菌粘附量均无明显差异（F=0.232, P>0.05）。扫描电子显微镜观察：XO、EO材料表面金黄色葡萄球菌和表皮葡萄球菌粘附较少，呈散在性分布；PMMA材料表面金黄色葡萄球菌和表皮葡萄球菌粘附量较多，并形成“网状”结构；三种材料镜片表面均有大量铜绿假单胞杆菌粘附，三者粘附形态及细菌数量无明显差别。结论PMMA材料表面细菌粘附数量高于BOSTON XO、BOSTON EO材料，体外条件下，硬性角膜接触镜材料透氧性的增加不提高镜片表面细菌粘附。目的研究等离子体表面处理对氟硅丙烯酸酯（XO, XO₂）材料硬性角膜接触镜镜片表面金黄色葡萄球菌和铜绿假单胞杆菌粘附数量的影响。方法分别将等离子体表面处理氟硅丙烯酸酯（XO-P, XO₂-P）硬性角膜接触镜片材料置于两种细菌悬液中培养，未处理镜片（XO, XO₂）为对照组。采用MTT比色法、旋涡震荡-菌落计数法和扫描电子显微镜观察研究材料表面细菌粘附能力。结果MTT比色法，XO-P、XO₂-P材料表面金黄色葡萄球菌粘附量均低于XO、XO₂（t=20.059, t=27.654, P<0.01）；XO-P材料表面铜绿假单胞杆菌粘附量低于XO（t=5.426, P<0.01），XO₂-P和XO₂材料表面铜绿假单胞杆菌粘附量差异无统计学意义（t=1.480, P>0.05）。旋涡震荡-菌落计数法显示，XO-P、XO₂-P材料表面金黄色葡萄球菌粘附量均低于XO、XO₂（t=9.786, t=7.547, P<0.01）；XO-P培养铜绿假单胞杆菌的粘附量低于XO（t=3.185, P<0.01），XO₂-P和XO₂培养铜绿假单胞杆菌的粘附量差异无统计学意义（t=1.485, P>0.05）。扫描电子显微镜观察，金黄色葡萄球菌在XO-P和XO₂-P表面呈孤立散在分布，在XO和XO₂表面呈团块状；铜绿假单胞杆菌在XO-P和XO₂-P表面稀疏分布，在XO和XO₂表面分布密集呈膜片状。结论等离子体处理后XO和XO₂材料均能有效降低金黄色葡萄球菌的表面粘附，但等离子体处理后XO₂对铜绿假单胞杆菌的粘附无明显影响。目的研究青少年近视者角膜塑形镜配戴前后结膜囊菌群比较，以及角膜塑形镜存储盒带菌情况。方法分别对101名配戴角膜塑形镜（配戴组），和110名未配戴角膜塑形镜者（对照组），进行结膜囊细菌培养，并对角膜塑形镜存储盒进行细菌培养。所有标本置于37℃温箱中培养48h后统计培养阳性率。结果配戴组结膜囊培养菌株59株，阳性率为29.35%，对照组结膜囊培养菌株68株，阳性率为30.90%，两组结膜囊细菌培养阳性率差别无统计学意义（χ²=0.12, P>0.05）。角膜塑形镜存储盒细菌培养菌株72株，阳性率为45.56%，前三位菌群与结膜囊培养结果一致。三组培养菌群构成示，前三位菌株基本一致，分别是表皮葡萄球菌、金黄色葡萄球菌和棒状杆菌菌属。结论配戴角膜塑形镜不提高青少年结膜囊细菌培养阳性率，镜片及镜盒的清洁可降低镜片污染率。更多还原

【Abstract】 ObjectiveTo observe the in vitro adherence ability of different bacteria （staphylococcus aureus,staphylococcus epidermidis and pseudomonas aeruginosa） to different rigid contact lenses（hexafoconA, enflufocon B and polymethyl methacrylate）.MethodsContact lenses were placed in bacterial suspension （0.5McF）.. Bacteria binding wasmeasured and analyzed by Methyl thiazolyl tetrazolium （MTT） assay, Spiraloscillation-bacterial culture quantitative method and scanning electron microscopy （SEM）.ResultsMTT assay: Adherence of staphylococcus aureus to XO was significant lower than toEO and PMMA （q=7.379，q=8.207, P<0.01）, no significant difference were found betweenEO and PMMA （q=0.828，P>0.05）. Adherence of staphylococcus epidermidis to XO and toEO was lower than to PMMA （q=14，q=12.8，P<0.01）, yet no significant differencebetween XO and EO （q=1.2，P>0.05）. There was no difference of pseudomonas aeruginosaadherence to all three kinds of contact lens （F=2.155, P>0.05）.Spiral oscillation-bacterial culture quantitative methods: Adherence of staphylococcusaureus to XO was higher than to EO, while to PMMA was the highest （q=11.65, q=28.64,q=16.99, P<0.01）. Adherence of staphylococcus epidermidis to XO was significantly lowerthan to PMMA （q=5.06, P<0.05）, no significant difference was found either between XOand EO or between EO and PMMA （q=3.29, q=1.77, P>0.05）. As for pseudomonas aeruginosa, no difference was found among the three contact lens （F=0.232, P>0.05）.SEM: Adherence of staphylococcus aureus and staphylococcus epidermidis was lowto both XO and EO, and the bacterial colonization distributed dispersedly. Yet bacterialadhesions of Staphylococcus aureus and staphylococcus epidermidis to PMAA wereapparent, and the colonization connected with each other to form a network. Bacterialattachments of pseudomonas aeruginosa were apparent to all of the three contact lens, andno significant difference among the three lens, both morphologically and quantitatively.ConclusionsIn vitro bacterial adherence to PMMA is higher than to XO and to EO. Theimprovement of gas-permeability of rigid contact lens might not increase in vitro bacterialadhesion. ObjectiveTo observe the influence of plasma surface treatment on adherence of staphylococcusaureus and pseudomonas aeruginosa to hexafocon （XO, XO₂）.MethodsPlasma treatment were conducted to XO and XO₂to obtain XO-P and XO₂-Prespectively. The four rigid contact lenses were placed into bacteria suspension （0.5McF）.We took XO and XO₂as control in this study. Bacteria binding was measured by Methylassay, Spiral oscillation-bacterial culture quantitative method and SEM.ResultsMTT assay shown the OD value of staphylococcus aureus suspension of XO-P was lower than XO, while XO₂-P lower than XO₂（t=20.059, t=27.654, P<0.01）. As forpseudomonas aeruginosa suspension, OD value of XO-P was lower than XO （t=5.426,P<0.01）, yet there was no difference between XO₂-P and XO₂（t=1.480, P>0.05）. Spiraloscillation-bacterial culture quantitative methods showed that the OD value ofstaphylococcus aureus of XO-P was lower than XO, as XO₂-P was lower than XO₂（t=9.786,t=7.547, P<0.01）. The OD value of pseudomonas aeruginosa of XO-P was lower than XO（t=3.185, P<0.01）, and no significant difference was found between XO₂-P and XO₂（t=1.485, P>0.05）. SEM showed that adhesion of staphylococcus aureus to XO-P andXO₂-P distributed dispersedly yet densely to XO and XO₂. Attachment of pseudomonasaeruginosa to XO-P and to XO₂-P were low， but distributed on XO and XO₂amembrane-like shape.ConclusionsXO-P and XO₂-P are effectively to reduce surface adhesion of staphylococcus aureus.But had no effect on the adhesion of XO₂-P of Pseudomonas aeruginosa. ObjectiveTo investigate status of bacterial flora in conjunctival sac of adolescents wearingorthokeratology and in their storage cases.Methods101adolescents wearing orthokeratology （wearing group） and110adolescents who do not wear （control group） were involved in our survey. Samples collected fromconjunctival sac and storage cases were cultured at37℃for48h.Results59strains of bacteria were cultured in wearing group, with a positive rate29.35%. Incontrol group,68strains were found, and the positive rate is30.90%. There was nosignificant difference between the two groups （χ²=0.12, P>0.05）.72strains of bacteriawere cultured in the orthokeratology lens storage cases, with a positive rate45.56%. Thetop three strains of bacteria in all of the three sources were basically the same, includingStaphylococcus epidermidis, Staphylococcus aureus and Corynebacterium.ConclusionsWearing orthokeratology lens did not significantly increased positive rate of bacterialflora. Simultaneously, it’s effective to reduce lens pollution rate by cleaning lens and cases.更多还原