Evans J
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8031, USA.
Curr Opin Rheumatol. 2000 Jul;12(4):311-7. doi: 10.1097/00002281-200007000-00014.
Lyme disease (LD) is the most common tick-borne disease in the US. The overall trend has been an average annual increase in cases since surveillance was initiated by the Centers for Disease Control and Prevention in 1982. To date, 10 different Borrelia species have been described within the Borrelia burgdorferi sensu lato complex, although only Borrelia burgdorferi sensu strico, Borrelia garinii, and Borrelia afzelii have been associated with human disease. Ixodes ticks often carry more than one potential pathogen, and co-infection with B. burgdorferi and other organisms have been reported. Recent findings suggested that maintenance cycles of other tick-borne pathogens may be different than those for B. burgdorferi. A better understanding of the pathogenesis of Lyme arthritis has provided clues about the mechanisms responsible for variation in clinical expression of the disease. Results of therapeutic trials in Lyme neuroborreliosis are likely to have an impact upon treatment recommendations. A long term follow-up study of children treated for LD indicated that the prognosis is excellent in most cases. A safe vaccine for the prevention of LD has been approved in adults. Preliminary data suggested that the vaccine is safe and immunogenic in children.
莱姆病（LD）是美国最常见的蜱传疾病。自1982年美国疾病控制与预防中心开始监测以来，病例数总体呈年均上升趋势。迄今为止，在广义伯氏疏螺旋体复合体中已描述了10种不同的疏螺旋体物种，不过只有狭义伯氏疏螺旋体、伽氏疏螺旋体和阿氏疏螺旋体与人类疾病有关。硬蜱通常携带不止一种潜在病原体，并且已有报告称存在伯氏疏螺旋体与其他生物体的共同感染。最近的研究结果表明，其他蜱传病原体的维持周期可能与伯氏疏螺旋体不同。对莱姆关节炎发病机制的更好理解为该疾病临床表型变异的相关机制提供了线索。莱姆神经疏螺旋体病治疗试验的结果可能会对治疗建议产生影响。一项对接受莱姆病治疗的儿童的长期随访研究表明，大多数情况下预后良好。一种用于预防莱姆病的安全疫苗已在成人中获得批准。初步数据表明该疫苗在儿童中是安全且具有免疫原性的。
