Aguero-Rosenfeld M E, Nowakowski J, McKenna D F, Carbonaro C A, Wormser G P
Department of Pathology, New York Medical College, Valhalla.
J Clin Microbiol. 1993 Dec;31(12):3090-5. doi: 10.1128/jcm.31.12.3090-3095.1993.
Using a commercially available enzyme-linked immunosorbent assay (ELISA) and an immunoblot assay (IB), we tested sera from 100 patients with erythema migrans (EM) seen in 1991 a the Westchester County Medical Center Lyme Disease Diagnostic Center. Convalescent-phase sera were available from 59 patients. Fifty-five patients had EM of < 7 days' duration, 31 had EM of 7 to 14 days' duration, and 14 had EM of > 14 days' duration. During the acute phase of infection, 35 patients had a positive ELISA result and 43 had a positive IB result by the recently published criteria of Dressler et al. (F. Dressler, J. A. Whalen, B. N. Reinhardt, and A. C. Steere, J. Infect. Dis. 167:392-400, 1993) for interpretation of IB in patients with Lyme disease. A greater sensitivity of IB was observed in patients with EM of < 7 days' duration, as follows: 14 of 55 (25%) for IB versus 7 of 55 (13%) for ELISA (P = 0.144). Sera of all 14 patients with EM of > 14 days' duration were reactive by both tests, as follows: 13 positive and 1 equivocal by ELISA and 12 positive and 2 indeterminate by the IB. The band reactivity most frequently observed in the IB was to the 41- and 25-kDa antigens, the latter being the most frequent band observed in immunoglobulin M blots. Seroconversion was observed in 74 and 64% of evaluable patients by ELISA and IB, respectively, despite the use of antibiotic therapy.
我们使用一种市售的酶联免疫吸附测定（ELISA）和免疫印迹测定（IB），检测了1991年在韦斯特切斯特县医学中心莱姆病诊断中心就诊的100例游走性红斑（EM）患者的血清。59例患者有恢复期血清。55例患者的EM病程小于7天，31例患者的EM病程为7至14天，14例患者的EM病程大于14天。根据德雷斯勒等人最近发表的标准（F.德雷斯勒、J.A.惠伦、B.N.莱因哈特和A.C.斯泰尔，《传染病杂志》167:392 - 400，1993年），在莱姆病患者中进行IB检测时，在感染急性期，35例患者的ELISA结果为阳性，43例患者的IB结果为阳性。在病程小于7天的EM患者中观察到IB具有更高的敏感性，如下：IB检测为55例中的14例（25%），而ELISA检测为55例中的7例（13%）（P = 0.144）。所有14例病程大于14天的EM患者的血清两种检测均呈反应性，如下：ELISA检测13例阳性，1例可疑；IB检测12例阳性，2例不确定。在IB检测中最常观察到的条带反应性是针对41 kDa和25 kDa抗原，后者是在免疫球蛋白M印迹中最常观察到的条带。尽管使用了抗生素治疗，但分别通过ELISA和IB检测，在可评估患者中观察到血清转化的比例分别为74%和64%。
