Honegr K, Hulínská D, Dostál V, Gebouský P, Hanková E, Horácek J, Vyslouzil L, Havlasová J
Infekcní klinika, Fakultní nemocnice, Hradec Králové.
Epidemiol Mikrobiol Imunol. 2001 Feb;50(1):10-6.
In 18 patients with Lyme borreliosis the authors proved the persistence of Borrelia burgdorferi sensu lato by detection of the causal agent by immune electron microscopy or of its DNA by PCR in plasma or cerebrospinal fluid after an interval of 4-68 months. Clinical manifestations common in Lyme borreliosis were present in only half the patients, in the remainder non-specific symptoms were found. In nine subjects with confirmed Borrelia burgdorferi sensu lato in the cerebrospinal fluid the cytological and biochemical finding was normal. Examination of antibodies by the ELISA method was negative in 7 of 18 patients during the first examination and in 12 of 18 during the second examination. In all negative examinations the specific antibodies were assessed by the Western blot or ELISA method after liberation from the immunocomplexes. In the authors' opinion it is advisable to examine repeatedly plasma and other biological material from potentially affected organs by PCR and subjects with persisting or relapsing complaints after the acute form of Lyme borreliosis as well as to examine cerebrospinal fluid in case on non-specific symptoms and concurrent pathic EEG or MR findings.
在18例莱姆病患者中,作者通过免疫电子显微镜检测病原体或通过PCR检测血浆或脑脊液中的DNA,证实了伯氏疏螺旋体狭义种在4 - 68个月的间隔后仍持续存在。莱姆病常见的临床表现仅出现在一半的患者中,其余患者出现非特异性症状。在9例脑脊液中确诊为伯氏疏螺旋体狭义种的受试者中,细胞学和生化检查结果正常。ELISA法检测抗体时,18例患者中有7例在首次检查时呈阴性,18例中有12例在第二次检查时呈阴性。在所有阴性检查中,从免疫复合物中释放后,通过免疫印迹法或ELISA法评估特异性抗体。作者认为,对于莱姆病急性期后持续存在或复发症状的患者,以及出现非特异性症状且伴有病理性脑电图或磁共振成像结果的患者,建议通过PCR反复检测血浆和其他可能受影响器官的生物材料,并检测脑脊液。