Hofmann H, Meyer-König U
Universitäts-Hautklinik Homburg, Saar.
Hautarzt. 1990 Aug;41(8):424-31.
185 patients with dermatological symptoms of Borrelia burgdorferi infection (erythema migrans, lymphadenosis cutis benigna, acrodermatitis chronica atrophicans) and morphea were examined for Borrelia burgdorferi antibodies; in addition, sera from 173 patients were tested for exclusion of Borrelia infection. Commercially available immunofluorescence tests and enzyme immunoassays supplied by four different companies were evaluated. To investigate the specificity of these assays, sera of 34 patients with syphilis in different stages and sera from 98 control persons were examined. None of the assays evaluated was suitable for the diagnosis of early infection (sensitivity 4-35%). However, they are more reliable for the diagnosis of late infection (sensitivity 56-100%). The variation in specificity between the different assays was 82-100%. Crossreactions with Borrelia burgdorferi antibodies occurred frequently in patients with syphilis (3-47%). The reliability of serological assays should be improved by antigen purification and combination of screening and confirmatory assays. After treatment the decline in IgG and IgM antibodies is very slow.
对185例有伯氏疏螺旋体感染皮肤症状（游走性红斑、良性皮肤淋巴腺病、慢性萎缩性肢端皮炎）和硬斑病的患者进行了伯氏疏螺旋体抗体检测；此外，检测了173例患者的血清以排除伯氏疏螺旋体感染。对四家不同公司提供的市售免疫荧光试验和酶免疫测定进行了评估。为研究这些检测方法的特异性，检测了34例不同阶段梅毒患者的血清以及98名对照者的血清。所评估的检测方法均不适用于早期感染的诊断（敏感性为4%-35%）。然而，它们对晚期感染的诊断更可靠（敏感性为56%-100%）。不同检测方法之间的特异性差异为82%-100%。梅毒患者中与伯氏疏螺旋体抗体的交叉反应频繁发生（3%-47%）。应通过抗原纯化以及筛查和确证检测相结合来提高血清学检测的可靠性。治疗后，IgG和IgM抗体下降非常缓慢。
