莱姆病的临床特点及处置要点

Clinical characteristics and disposal points of Lyme disease

莱姆病是由伯氏疏螺旋体(Borrelia burgdorferi)引起的自然疫源性疾病,发病地区不断扩展蔓延,发病率逐年上升,其中,森苏疏螺旋体(B.burgdorferi sensu)、阿氏疏螺旋体(Borrelia afzelii)和加里尼疏螺旋体(Borrelia garinii)等三种基因分型的伯氏疏螺旋体与莱姆病发病密切相关。莱姆病螺旋体基因型的分布与地理环境、媒介生物、宿主动物密切相关,不同基因型引起的临床表现差异巨大。莱姆病临床表现可分为三个阶段:早期局灶期表现为蜱虫叮咬部位的游走性红斑,播散期可出现多发性红斑、螺旋体淋巴细胞瘤、神经系统莱姆病、心肌炎或关节炎,晚期发散期表现为慢性萎缩性关节炎和神经系统损伤症状。

Lyme disease is a tick-borne disease,transmitted by hard tick of the Ixodes genus.Its incidence and geographic expansion has been steadily increasing year by year.Lyme disease is a natural focal disease caused by Borrelia burgdorferi,the incidence area continues to expand and spread,and the incidence rate is increasing year by year,among them,three genotypes of Borrelia burgdorferi such as B.burgdorferi sensu,Borrelia afzelii and Borrelia garinii are closely related to the incidence of Lyme disease.The distribution of Borrelia burgdorferi genotypes is closely related to geographical environment,vectors and host animals,different genotypes cause great differences in clinical manifestations.The clinical manifestations of Lyme disease can be divided into three stages: the early localized stage is characterized by migratory erythema at the tick and bite site;the multiple erythema,spirochete lymphoma,nervous system sickness,myocarditis or arthritis can appear in the disseminated infection stage;while the late sdiffusion stage shows chronic atrophic arthritis,and neurological injury symptoms.