联合抗真菌方案经治真菌性角膜炎患者复发风险及危险因素分析OA

Objective To investigate the recurrence risk and associated risk factors in fungal keratitis(FK)patients after combined antifungal therapy.Methods A total of 267 patients(267 eyes)with fungal keratitis(FK)treated at Xiaogan Central Hospital of Hubei Province、Xiaogan First People's Hospital and Xiaochang First People's Hospital from January 2021 to March 2024 were prospectively enrolled..All patients received combined antifungal therapy(amphotericin B plus voriconazole).Based on recurrence within 1 month after treatment completion,patients were categorized into recurrence and non-recurrence groups.Clinical data from both groups were collected and analyzed to identify risk factors for recurrence in FK patients following combined antifungal therapy.Results The recurrence rate of FK patients after combined antifungal therapy was 30.08%.Comparative analysis of clinical data between the two groups revealed no statistically significant differences in general characteristics such as age,sex,or BMI(P＞0.05).However,significant intergroup differences were observed in disease duration,infiltration depth,ulcer area,hypopyon,and residence(P＜0.05).Logistic regression analysis identified prolonged disease duration(OR=1.157),deeper infiltration(OR=2.330),larger ulcer area(OR=1.714),more severe hypopyon(OR=2.499),and rural residence(OR=1.940)as independent risk factors for recurrence after combined antifungal therapy(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under the curve(AUC)for disease duration,infiltration depth,ulcer area,hypopyon,and residence were 0.610,0.644,0.701,0.614,and 0.609,respectively.The combined predictive model yielded an AUC of 0.872 for recurrence prediction.Conclusion The recurrence rate of FK patients after combined antifungal therapy was 30.08%.Prolonged disease duration,deeper infiltration,larger ulcer area,more severe hypopyon,and rural residence were identified as independent risk factors for recurrence following combined antifungal treatment.