Niścigorska J
Katedry i Kliniki Chorób Zakaźnych, Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1999;45:157-73.
The aim of the study was to assess if Szczecin voivodeship is an area of endemic borreliosis, assess the risk due to B. burgdorferi infection in habitants and evaluate clinical manifestations of borreliosis. The study was conducted in 1993-1995, material comprised 299 persons (211 men and 88 women) aged from 3 to 78 years, divided into two groups. Group I consisted of foresters working in four forestry districts, occupationally exposed to tick bite. Group II was completed of Szczecin voivodeship habitants, sporadically exposed to tick bite. Control group consisted of 30 healthy persons without exposure to tick bite. Research programme of study comprised epidemiologic data, clinical examination, evaluation of serum anti-B.b antibodies in all persons and assessment of some infectious parameters (red cells sedimentation--RCS, leukocytosis and C-Reactive Protein--CRP) during borreliosis. High prevalence of borreliosis was noted in both groups. Risk of borreliosis was similar in four forestry districts (Tab. 1). The hazard of infection was not restricted to forest areas only but was present in some parts of Szczecin and its suburbs (parks and gardens). Infection by B.b. was observed in both males and females in all age groups. Risk of B.b infection increased accordingly to duration of exposure but in some examined persons after single tick bite the disease developed (Tab. 2). Some of infected persons do not demonstrate clinical symptoms of borreliosis (Tab. 3). In most cases the disease was diagnosed in early stage of infection (Tab. 4). During infection different organs and systems were involved (Tab. 5). In clinical study skin was the most often affected organ followed by nervous system and joints (Tab. 5, 7). Clinical manifestations comprised erythema migrans chronicum, radiculitis, arthritis, meningitis, encephalitis and uveitis (Tab. 6). Serological study revealed the presence of serum anti-B.b antibodies in 47.6% of examined persons with occupational risk involving tick bite, and 32.7% persons of sporadic risk with negative serology of borreliosis in control group (Tab. 8). The parameters of acute inflammatory phase (RCS, CRP, leukocytosis) are of limited value in diagnosis of borreliosis.
该研究的目的是评估什切青省是否为莱姆病的地方性流行区，评估居民感染伯氏疏螺旋体的风险，并评估莱姆病的临床表现。研究于1993年至1995年进行，研究对象包括299人（211名男性和88名女性），年龄在3岁至78岁之间，分为两组。第一组由在四个林区工作的林业工人组成，职业上易受蜱叮咬。第二组由什切青省的居民组成，偶尔会受到蜱叮咬。对照组由30名未接触蜱叮咬的健康人组成。研究方案包括流行病学数据、临床检查、所有人血清抗伯氏疏螺旋体抗体的评估以及莱姆病期间一些感染参数（红细胞沉降率——RCS、白细胞增多和C反应蛋白——CRP）的评估。两组中莱姆病的患病率都很高。四个林区莱姆病的风险相似（表1）。感染风险不仅限于森林地区，在什切青及其郊区的一些地方（公园和花园）也存在。所有年龄组的男性和女性都观察到了伯氏疏螺旋体感染。伯氏疏螺旋体感染的风险随着接触时间的延长而增加，但在一些接受检查的人单次被蜱叮咬后就发病了（表2）。一些感染者没有表现出莱姆病的临床症状（表3）。在大多数情况下，该病在感染的早期阶段被诊断出来（表4）。感染期间不同的器官和系统受到影响（表5）。在临床研究中，皮肤是最常受影响的器官，其次是神经系统和关节（表5、7）。临床表现包括慢性游走性红斑、神经根炎、关节炎、脑膜炎、脑炎和葡萄膜炎（表6）。血清学研究显示，在有职业性蜱叮咬风险的受检者中，47.6%的人血清中存在抗伯氏疏螺旋体抗体，对照组中偶发性风险的人群中有32.7%的人莱姆病血清学检测呈阴性（表8）。急性炎症期参数（RCS、CRP、白细胞增多）在莱姆病诊断中的价值有限。
