延边地区60例莱姆病回顾性分析

Retrospective analysis of 60 cases of Lyme disease in Yanbian area

[目的]分析延边地区莱姆病的临床特征、实验室检查特点、诊断、治疗及预后.[方法]选择2006年6月—2017年8月间诊断为莱姆病的60例患者的临床资料进行比较分析.[结果]60例莱姆病患者中男性和女性各为30例;平均年龄48.68岁(8~75岁);均有蜱媒叮咬史;患者职业以林场职工和农民为主,共34例(56.7%);发病集中在6,7月份;主要临床表现为慢性游走性红斑(ECM)、发热、头痛及关节炎等;血沉升高者占77.8%(7/9例);白细胞数正常但中性粒细胞轻度增高者31例(51.7%),淋巴细胞下降者26例(43.3%);抗生素及糖皮质激素是治疗莱姆病的有效药物.[结论]莱姆病在任何年龄均可发病,男性及女性发病无明显差异,好发于林场职工和农民,蜱叮咬是重要传播途径,临床表现以ECM、头痛、发热为主,实验室检查结果可见ESR及中性粒细胞增高.

OBJECTIVE To analyze the clinical features,laboratory features,diagnosis,treatment and prognosis of Lyme disease in Yanbian area.METHODS Clinical data of 60 patients diagnosed with Lyme disease between June 2006 and August 2017 were compared and analyzed.RESULTS Of the 60 patients,30 were male and 30 were female.The average age was 48.68 years old（8~75 years old）.All of them had a history of tick bites.The occupation of the patients was mainly forest farm workers and farmers,a total of 34 cases（56.7%）. The incidence was concentrated in June and July.The main clinical manifestations were erythema chronicum migrans（ECM）,fever,headache and arthritis.The patients who had increasing erythrocyte sedimentation rate（ESR）accounted for 77.8%（7/9 cases）.There were 31 cases with normal white blood cell count but mild increase of neutrophil（51.7%）,and 26 cases with decreased lymphocyte（43.3%）.Antibiotics and glucocorticoids were effective drugs for Lyme disease.CONCLUSIONLyme disease could occur at any age,but there was no significant difference between male and female.It tended to occur in forest farm workers and farmers.Tick biting was an important route of transmission.The clinical manifestations were ECM,headache and fever.The results of laboratory tests showed that ESR and neutrophil were increased.