105例拟诊莱姆病患者抗伯氏疏螺旋体抗体检查结果分析

Borrelia burgdorferi antibody levels in 105 patients with suspected Lyme disease

目的分析拟诊莱姆病患者血清学检查结果,明确莱姆病临床病症及区域分布情况,为有效诊治莱姆病提供科学依据。方法应用间接免疫荧光试验(IFA)和ELISA方法,对来自全国各地的临床拟诊莱姆病患者进行血清抗伯氏疏螺旋体IgM和IgG抗体检查,并结合临床疾患进行综合分析。结果2007-2008年共检查临床拟诊莱姆病患者105例,血清呈阳性反应者16例,阳性率15.24%。其中神经系统患者44例,阳性4例;心血管系统患者5例,阳性1例;皮肤病变25例,阳性6例;发热患者10例,阳性1例;关节痛14例,阳性2例;精神障碍疾患7例,阳性2例。16例患者应用抗生素治疗后有效率达87.50%。16例莱姆病患者分布在9个省(直辖市、自治区),确诊病例以黑龙江、吉林、内蒙古地区较多。结论我国人群确实存在莱姆病螺旋体散发感染,通过血清学检查能及早发现病例,提高诊疗效率。

Objective To identify the clinical manifestations and regional distribution of Lyme disease by analyzing the serological testing for suspected patients, providing scientific evidence for proper management of the disease. Methods The indirect immunofluorescenee assay （IFA） and the enzyme-linked immune sorbent assay （ELISA） were employed for the detection of serum antibodies（IgM, IgG） against Borrelia burgdoG;eri for suspected Lyme disease patients. The results were then comprehensively interpreted combining clinical manifestations. Results From 2007 to 2008, a total of 105 suspected Lyme disease patients were subject to the analysis, resulting in 16 positives （15.24%）, including 4 out of 44 patients with neurological disorders; 1 out of 5 patients with cardiovascular conditions, 6 out of 25 patients with skin lesions; 1 out of 10 fever patients; 2 out of 14 arthralgia patients; and 2 out of 7 patients with mental disorders, Of the 16 patients distributed in 9 provinces, 87.50% responded favorably to the application of antibiotics. Most confirmed patients were from Heilongjiang, Jilin and Inner Mongolia. Conclusion Sporadic spirochete infections were observed in Chinese population. Serological testing contributes to the early detection of Lyme disease and the improvement of efficient diagnosis and treatment.