Rahn D W, Malawista S E
Yale University School of Medicine, Section of Rheumatology, New Haven, CT 06510-8056.
Ann Intern Med. 1991 Mar 15;114(6):472-81. doi: 10.7326/0003-4819-114-6-472.
The incidence and the endemic range of Lyme disease in the United States have increased steadily since the disease was originally recognized in Lyme, Connecticut, in 1975. Because of the varied clinical manifestations of this illness and the use of unstandardized serologic testing methods, diagnosis is often uncertain and treatment outcomes are often difficult to evaluate. The antibiotic regimens that are commonly used in clinical practice have changed rapidly. They show much regional variation with little critical comparison of treatment results. The clinical diagnosis and the literature on the treatment of the various stages of Lyme disease are reviewed. The reported data are supplemented with recommendations based on 15 years of clinical experience with this illness.
自1975年在美国康涅狄格州莱姆镇首次发现莱姆病以来，美国莱姆病的发病率和流行范围一直在稳步上升。由于这种疾病临床表现多样，且使用的血清学检测方法不标准，诊断往往不明确，治疗结果也常常难以评估。临床实践中常用的抗生素治疗方案变化迅速。它们存在很大的地区差异，对治疗结果的关键比较却很少。本文回顾了莱姆病各阶段的临床诊断及治疗文献。报告的数据辅以基于15年该疾病临床经验的建议。
