Lipsker D, Hansmann Y, Limbach F, Clerc C, Tranchant C, Grunenberger F, Caro-Sampara F, Attali P, Frey M, Kubina M, Piémont Y, Sibilia J, Jaulhac B
Clinique Dermatologique, Strasbourg, France.
Eur J Clin Microbiol Infect Dis. 2001 Apr;20(4):225-30. doi: 10.1007/s100960100476.
Since very little is known about the clinical expression of Lyme borreliosis in Western Europe, a 3-year prospective study was conducted that included all patients seen for suspected Lyme borreliosis at the Strasbourg University Hospital in northeastern France. The diagnosis of Lyme borreliosis was made on the basis of the presence of erythema migrans or on the basis of another suggestive clinical manifestation and laboratory confirmation. A total of 132 patients, 70 women and 62 men, mean age 54 years, had Lyme borreliosis according to these criteria. Within this study group, 77% of the patients were regularly exposed to tick bites and 64% could remember one. Erythema migrans, the most frequent clinical manifestation, occurred in 60% of the patients and was the only sign of Lyme borreliosis in 40%. Lymphocytoma and acrodermatitis chronica atrophicans were rare (1 and 3 patients, respectively). Nervous system involvement (mainly radiculoneuropathy), the second most common clinical manifestation, was found in 40% of the patients and was the only sign of Lyme borreliosis in 22%. Musculoskeletal involvement was present in 26% of the patients and was an isolated finding in 14%. During the study period, no patient was diagnosed with Lyme carditis. There was serological evidence of Lyme borreliosis in 75% of the cases and direct evidence of borrelial infection in 10 (7.5%). The results show that the clinical expression of Lyme borreliosis in northeastern France is similar to that in other European countries but different from that in North America.
由于人们对莱姆病在西欧的临床表现了解甚少，因此开展了一项为期3年的前瞻性研究，纳入了法国东北部斯特拉斯堡大学医院所有疑似莱姆病的患者。莱姆病的诊断基于游走性红斑的存在，或基于其他提示性临床表现及实验室确诊。根据这些标准，共有132例患者患有莱姆病，其中70例女性，62例男性，平均年龄54岁。在这个研究组中，77%的患者经常暴露于蜱叮咬，64%的患者能记起一次蜱叮咬。游走性红斑是最常见的临床表现，60%的患者出现该症状，40%的患者中它是莱姆病的唯一症状。淋巴细胞瘤和慢性萎缩性肢端皮炎较为罕见（分别为1例和3例患者）。神经系统受累（主要是神经根神经病）是第二常见的临床表现，40%的患者出现该症状，22%的患者中它是莱姆病的唯一症状。26%的患者存在肌肉骨骼受累，14%的患者中它是孤立发现。在研究期间，没有患者被诊断为莱姆心肌炎。75%的病例有莱姆病的血清学证据，10例（7.5%）有伯氏疏螺旋体感染的直接证据。结果表明，法国东北部莱姆病的临床表现与其他欧洲国家相似，但与北美不同。
