Łapiński Tadeusz Wojciech, Grzeszczuk Anna, Prokopowicz Danuta
Klinika Obserwacyjno-zakaźna Akademii Medycznej w Białymstoku.
Pol Merkur Lekarski. 2003 Mar;14(81):236-8.
Lyme arthritis is a frequent manifestation of Borrelia burgdorferi sensu lato infection. The relapses of Lyme arthritis are observed despite effective antibiotic therapy of acute Lyme disease.
This study was undertaken in order to determine the efficacy and tolerability of antibiotic treatment of Lyme arthritis with oral doxycycline and intravenous ceftriaxone and to evaluate the relapse rate of the arthritis after treatment.
The study group consisted of 64 patients. Twenty five were treated orally with doxycycline (Doxycyclini hyclas) 0.2 g/day and 39 were treated intravenously with ceftriaxone (Ceftriaxonum natricum) 2.0 g/day; treatment duration in both groups was 28 days.
The symptoms of arthritis were most often seen in knee joints--45 patients (70%), then in shoulder joints--20 patients (31%), less frequently in ankle joints, elbow joints. In all patients remission of symptoms was seen after the treatment. The relapse of arthritis was seen slightly more frequently among patients treated with doxycycline 36% (9/25) than among those treated with ceftriaxone--23% (9/35), p = 0.402. The relapse was observed most often among patients older then 50 years.
The relapse of Lyme arthritis was seen in about 28% of patients, mainly older than 50 years it and did not depend on the antibiotic administered.
莱姆关节炎是伯氏疏螺旋体广义感染的常见表现。尽管对急性莱姆病进行了有效的抗生素治疗，但仍观察到莱姆关节炎的复发。
本研究旨在确定口服多西环素和静脉注射头孢曲松治疗莱姆关节炎的疗效和耐受性，并评估治疗后关节炎的复发率。
研究组由64名患者组成。25名患者口服多西环素（多西环素氢氯噻嗪）0.2g/天，39名患者静脉注射头孢曲松（头孢曲松钠）2.0g/天；两组治疗持续时间均为28天。
关节炎症状最常出现在膝关节——45名患者（70%），其次是肩关节——20名患者（31%），踝关节、肘关节出现的频率较低。所有患者治疗后症状均缓解。多西环素治疗的患者关节炎复发率略高于头孢曲松治疗的患者，分别为36%（9/25）和23%（9/35），p = 0.402。复发最常出现在50岁以上的患者中。
约28%的患者出现莱姆关节炎复发，主要是50岁以上的患者，且复发不取决于所使用的抗生素。
