Zbinden R, Stech J, Bürgi W, Meier T
Mikrobiologisches Institut, Kantonsspitals Aarau.
Schweiz Med Wochenschr. 1993 Dec 4;123(48):2293-8.
Neurologic complications are common in Lyme borreliosis. In adults in particular, detection of intrathecally formed antibodies to B. burgdorferi is a decisive diagnostic criterion. As in neurosyphilis diagnosis, the specific antibody titer against B. burgdorferi in the CSF is compared with the serum titer by calculating the specific antibody indices, taking into account the disturbed blood/CSF barrier. Deriving from these specific indices, we adapt by dilution the serum IgG level to that in the CSF of the same day, thus allowing for passive diffusion of antibody through the blood/CSF barrier. Determination of the specific antibody titer by indirect immunofluorescence demonstrates intrathecal synthesis of specific antibodies against B. burgdorferi if the CSF titer is higher than in the diluted serum tested in parallel. The individual methods are presented in a group of patients.
神经并发症在莱姆病螺旋体病中很常见。特别是在成年人中，检测鞘内形成的抗伯氏疏螺旋体抗体是一个决定性的诊断标准。如同神经梅毒的诊断一样，通过计算特异性抗体指数，将脑脊液中抗伯氏疏螺旋体的特异性抗体滴度与血清滴度进行比较，同时考虑到血脑屏障的破坏。根据这些特异性指数，我们通过稀释将血清IgG水平调整到同一天脑脊液中的水平，从而使抗体能够通过血脑屏障进行被动扩散。如果脑脊液滴度高于平行检测的稀释血清滴度，则通过间接免疫荧光法测定特异性抗体滴度可证明鞘内合成了抗伯氏疏螺旋体的特异性抗体。在一组患者中展示了各个方法。
