海南省关节炎和神经系统疾病患者莱姆病调查

Investigation on Lyme Disease of patients with arthritis or neurological disorders in Hainan Province,China

目的了解我国海南省关节炎或神经性疾病患者的莱姆病感染状况,并确认海南省是否存在莱姆病人。方法海南省三亚市人民医院提供血清542份,均为关节炎或神经性疾病患者。采用间接免疫荧光法(Indirect Fluorescent-Antibody Test,IFA)和免疫印迹法(Western Blot,WB)对血清标本进行莱姆病抗体检测;并采用巢式PCR法对WB抗体阳性的血清标本进行病原学检测。结果 IFA方法检测血清样本542份,54份阳性,阳性率为9.96%。应用WB法对上述54份IFA阳性血清样本进行检测,12份阳性。采用巢式PCR方法检测12份WB阳性样本,2份阳性,测序结果表明两份均为B.garinii基因型。结论本研究证实了海南省人群中存在莱姆病。建议当地医生在诊治关节炎和神经性疾病患者时,可以考虑其是否罹患莱姆病。

To investigate the infection status of Lyme spirochete in patients with arthritis or neurological disease in Hainan Province of China, and to confirm the presence of Lyme disease in Hainan Province, a total of 542 serum samples with arthritis or nervous system disease suspected with B. burgdorferi infection were collected from Sanya Peoples＇ Hospital, Hainan Prov- ince. Antibodies for Lyme disease in serum samples were detected by Indirect Fluorescent-Antibody Test （IFA） and Western blot （WB） ; and the nested PCR method was used to test the pathogen in the WB positive serum samples. Results showed that 54 in total of 542 serum samples were tested positive by IFA, the positive rate was 9.96%. In the 54 IFA-positives, 12 were confirmed positive by WB. Two in 12 WB confirmed positives were tested positive by nested PCR. Sequence analysis showed the two samples were infected by B. garinii strains. This research confirmed the existence of human Lyme disease in Hainan Province. We suggested that Lyme disease should he commonly considered by clinicians when the patients had some related symptoms of Lyme disease in Hainan, China.