Strickland G T, Karp A C, Mathews A, Peña C A
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
J Infect Dis. 1997 Sep;176(3):819-21. doi: 10.1086/517311.
To ascertain use of serologic tests for Lyme disease (LD) in Maryland, all laboratories registered with the State Health Department were surveyed. Results show that from 1992 to 1995, 17 laboratories performed 100,000 serologic tests costing $7.1 million on Maryland residents; 90% of these tests were EIAs. The proportion of positive EIAs increased from 3.4% in 1992 to approximately 7.0% in 1994 and 1995, and the percentage of positive second tests (Western blot, WB) fell from 7.9% to 5.0%-5.5%. The large number of EIAs performed in comparison with the low incidence of LD in the state results in a low predictive value of a positive EIA test. Therefore, the WB is indicated to confirm equivocal and positive EIA tests when characteristic clinical findings of LD are not present. The 30,000 tests for LD performed annually on Maryland residents at a cost of over $2 million in direct medical costs must be added to the public health burden of LD in this state.
为确定马里兰州莱姆病（LD）血清学检测的使用情况，对向州卫生部注册的所有实验室进行了调查。结果显示，1992年至1995年期间，17个实验室对马里兰州居民进行了10万次血清学检测，花费710万美元；其中90%的检测为酶免疫测定（EIA）。EIA检测阳性比例从1992年的3.4%增至1994年和1995年的约7.0%，而第二次检测（免疫印迹法，WB）阳性百分比从7.9%降至5.0% - 5.5%。与该州LD低发病率相比，大量的EIA检测导致EIA检测阳性的预测价值较低。因此，当不存在LD的特征性临床发现时，建议采用WB来确认可疑和阳性的EIA检测结果。每年对马里兰州居民进行的3万次LD检测，直接医疗费用超过200万美元，这必须计入该州LD的公共卫生负担。
