牡丹江林区342例莱姆病疑似患者血清学检测结果分析

Analysis on the Result of Detecting Serum from 342 Patients with Suspected Lyme Disease in Mudanjiang Forestry Area

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 2009年在牡丹江林业中心医院就诊患者中进行调查,并采集血液标本,用间接免疫荧光法(IFA)进行人群血清莱姆病螺旋体抗体(IgG)检查,结合流行病学史、临床表现和实验室检查结果了解莱姆病感染情况。结果对342人进行了调查,判定为莱姆病感染的为58例,感染率为16.96%。除牡丹江市区人群感染率较低外,周边各县感染率差异无统计学意义(χ2=0.24,P>0.05)。不同临床表现的阳性率分别是,神经系统疾患21.74%(20/92);关节炎30.77%(12/39);皮肤病变12.82%(10/78);发热者16.67%(6/36);心血管系统疾患10.34%(3/29);其他症状患者10.29%(7/68)。有蜱叮咬史者血清抗体(IgG)平均阳性率为67.95%,没有蜱叮咬史者血清抗体(IgG)平均阳性率为1.89%,有蜱叮咬史者抗体阳性率要明显高于没有蜱叮咬史者,其差异有统计学意义(χ2=186.55,P<0.05)。结论牡丹江地区是莱姆病的疫区,人群确实存在莱姆病螺旋体散发感染,提示在牡丹江市地区开展莱姆病防治工作非常有必要。

Objective To investigate the Lyme Borreliosis infection status of population and epidemiological characteristic in Mudanjiang so as to put forward the preventive measures. Methods We collected serological samples of patient in Mudanjiang forestry center hospital in 2009,IgG antibodies against Borrelia burgdorferi were detected by means of indirect immunofluorescence assay（IFA）, by epidemiology,clinical symptoms and serological results to understand the epidemic status of Lyme disease in Mudanjiang. Results Investigation was conducted among 342 people,58 persons were found to be positive in serum antibody IgG, and the positive ratio was 16.96%.The positive ratio was lower in the Mudanjiang city than in surrounding counties, but there were no significant difference（χ2=0.24, P0.05）. The positive constitution ratio of the neurological disorders、arthritis、skin disorders、fever patients、cardiovascular system patients、and other symptom is 21.74%, 30.77%, 12.82%, 16.67%, 10.34% and 10.29% respectively. The positive rate of serological antibodies（IgG） of people with a history of tick bites（67.95%） is higher than those without tick bites（1.89%）, there were significant difference（χ2=186.55, P0.05）. Conclusion Mudanjiang area is endemic areas of Lyme disease, and there are lots of scattered cases of Lyme disease truly in Mudanjiang, so the prevention and treatment must be enhanced.