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[莱姆病螺旋体病的诊断]

[Diagnosis of Lyme borreliosis].

作者信息

Schneider E

机构信息

Neurologischen Abteilung, Allgemeinen Krankenhauses Harburg, Hamburg.

出版信息

Versicherungsmedizin. 1995 Jun 1;47(3):75-9.

PMID:7610528
Abstract

Lyme borreliosis is an infectious disease, caused by the spirochaete Borrelia burgdorferi and transmitted by ticks, in our regions by the tick Ixodes ricinus. The disease mainly affects skin, nervous system, joints and heart. Lyme borreliosis develops in three stages, and the various clinical manifestations may assigned to the respective stages. As far as skin is concerned, in stage I typically appears erythema chronicum migrans, very often accompanied by flu-like symptoms; in stage III, months to years after the manifestations of the early phase, acrodermatitis chronica atrophicans, may be encountered. Among the neurological manifestations, in stage II, meningoradiculoneuritis (Bannwarth's syndrome) develops as the most frequent disease, characterized by pheripheral paresis at the lower extremities and bilateral facial nerve palsy. Lyme arthritis mainly affects the knee. To assure the diagnosis of Lyme borreliosis, a number of serological tests is performed as the direct detection of the causative agent is rather difficult and time consuming. Possibly, the use of the polymerase chain reaction to detect B. burgdorferi DNA may improve the diagnostic tools.

摘要

莱姆病是一种由伯氏疏螺旋体引起的传染病,通过蜱虫传播,在我们地区由蓖麻硬蜱传播。该疾病主要影响皮肤、神经系统、关节和心脏。莱姆病发展分为三个阶段,各种临床表现可归属于相应阶段。就皮肤而言,在第一阶段通常出现慢性游走性红斑,常伴有流感样症状;在第三阶段,在早期表现出现数月至数年之后,可能会出现慢性萎缩性肢端皮炎。在神经学表现中,在第二阶段,脑膜神经根神经炎(班沃特综合征)是最常见的疾病,其特征为下肢周围性麻痹和双侧面神经麻痹。莱姆关节炎主要影响膝关节。为确保莱姆病的诊断,由于直接检测病原体相当困难且耗时,需进行多项血清学检测。可能的话,使用聚合酶链反应检测伯氏疏螺旋体DNA或许能改进诊断工具。

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