Bartůnek P, Gorican K, Mrázek V, Varejka P, Veiser T, Hercogová J, Hulínská D, Janovská D
Fourth Department of Medicine of the First Faculty of Medicine, Charles University in Prague, Czech Republic.
Prague Med Rep. 2006;107(2):213-26.
The relatively low percent of patients affected with the cardiac form of Lyme borreliosis is difficult to diagnose, especially if the disease manifests itself in ways other than atrio-ventricular blockade. The advanced stage of Lyme carditis manifesting as dilated cardiomyopathy is a special case of this affliction. The authors of this report present clinical experience with an attempt to support the working hypothesis about involvement of Lyme borreliosis infection in the development of dilated cardiomyopathy. The patients were clinically examined thoroughly with special attention to the cardiovascular system. In addition to the basic clinical methods, the following procedures have been employed: dynamic Holter's electrocardiography, exercise ECG test, coronarography, and myocardial biopsy. From laboratory methods pertaining to the detection of Borrelia, ELISA method, Western blot, PCR, electron microscopy and histopathological analysis were used. In all three cases, clinical and laboratory findings provided the evidence of the borreliosis infection involvement in the development of dilated cardiomyopathy.
感染心脏型莱姆病的患者比例相对较低，这种疾病很难诊断，尤其是当它以房室传导阻滞以外的方式表现出来时。莱姆心肌炎的晚期表现为扩张型心肌病，是这种疾病的一种特殊情况。本报告的作者介绍了临床经验，试图支持关于莱姆病感染参与扩张型心肌病发展的工作假设。对患者进行了全面的临床检查，特别关注心血管系统。除了基本的临床方法外，还采用了以下检查：动态心电图监测、运动心电图测试、冠状动脉造影和心肌活检。在检测伯氏疏螺旋体的实验室方法中，使用了酶联免疫吸附测定法（ELISA）、免疫印迹法、聚合酶链反应（PCR）、电子显微镜检查和组织病理学分析。在所有三例病例中，临床和实验室检查结果都证明了莱姆病感染参与了扩张型心肌病的发展。
