Cooper Lilli, Branagan-Harris Michael, Tuson Richard, Nduka Charles
Plastic Surgery Department, Queen Victoria Hospital, East Grinstead, West Sussex.
Health analytics and NHS policy expert, Device Access UK Ltd, Michelmersh, Hampshire.
Br J Gen Pract. 2017 May;67(658):e329-e335. doi: 10.3399/bjgp17X690497. Epub 2017 Apr 10.
Lyme disease is caused by a tick-borne spirochaete of the species. It is associated with facial palsy, is increasingly common in England, and may be misdiagnosed as Bell's palsy.
To produce an accurate map of Lyme disease diagnosis in England and to identify patients at risk of developing associated facial nerve palsy, to enable prevention, early diagnosis, and effective treatment.
Hospital episode statistics (HES) data in England from the Health and Social Care Information Centre were interrogated from April 2011 to March 2015 for International Classification of Diseases 10th revision (ICD-10) codes A69.2 (Lyme disease) and G51.0 (Bell's palsy) in isolation, and as a combination.
Patients' age, sex, postcode, month of diagnosis, and socioeconomic groups as defined according to the English Indices of Deprivation (2004) were also collected.
Lyme disease hospital diagnosis increased by 42% per year from 2011 to 2015 in England. Higher incidence areas, largely rural, were mapped. A trend towards socioeconomic privilege and the months of July to September was observed. Facial palsy in combination with Lyme disease is also increasing, particularly in younger patients, with a mean age of 41.7 years, compared with 59.6 years for Bell's palsy and 45.9 years for Lyme disease ( = 0.05, analysis of variance [ANOVA]).
Healthcare practitioners should have a high index of suspicion for Lyme disease following travel in the areas shown, particularly in the summer months. The authors suggest that patients presenting with facial palsy should be tested for Lyme disease.
莱姆病由该物种的蜱传螺旋体引起。它与面神经麻痹有关，在英国日益常见，可能被误诊为贝尔麻痹。
绘制英国莱姆病诊断的精确地图，并识别有发生相关面神经麻痹风险的患者，以实现预防、早期诊断和有效治疗。
从健康与社会保健信息中心获取2011年4月至2015年3月英格兰医院病历统计（HES）数据，查询国际疾病分类第10版（ICD - 10）代码A69.2（莱姆病）和G51.0（贝尔麻痹），单独及组合情况。
还收集了患者的年龄、性别、邮政编码、诊断月份以及根据英国贫困指数（2004年）定义的社会经济群体信息。
2011年至2015年期间，英国莱姆病的医院诊断每年增长42%。绘制出了发病率较高的区域，主要为农村地区。观察到社会经济特权倾向以及7月至9月的发病趋势。莱姆病合并面神经麻痹的情况也在增加，尤其是在年轻患者中，平均年龄为41.7岁，而贝尔麻痹患者的平均年龄为59.6岁，莱姆病患者的平均年龄为45.9岁（方差分析[ANOVA]，P = 0.05）。
医疗从业者在去过所示地区旅行后，尤其是在夏季月份，应对莱姆病保持高度怀疑指数。作者建议，出现面神经麻痹的患者应进行莱姆病检测。
