血清抗伯氏疏螺旋体抗体在葡萄膜炎诊断检查中的意义。
The significance of serum anti-Borrelia antibodies in the diagnostic work-up of uveitis.
作者信息
Mikkilä H, Seppälä I, Leirisalo-Repo M, Karma A
机构信息
Department of Ophthalmology, University of Helsinki, Finland.
出版信息
Eur J Ophthalmol. 1997 Jul-Sep;7(3):251-5. doi: 10.1177/112067219700700309.
PURPOSE
To assess the utility of testing uveitis patients for anti-Borrelia antibodies in an area endemic for Lyme borreliosis.
METHODS
We examined 161 uveitis patients for serum antibodies to Borrelia burgdorferi by Lyme ELISA. Antibodies were determined in patients with uveitis of unknown etiology and non-selectively from patients with an established diagnosis.
RESULTS
Concentrations of antibodies to B. burgdorferi were elevated in 26 uveitis patients (16.1%), with elevated IgG in 11 of them (6.8%). In four of these patients Lyme borreliosis was a highly suggestive cause of uveitis because of a history of tick bites, systemic symptoms, response to antibiotic therapy, and/or a positive polymerase chain reaction result. Other causes of uveitis were ruled out. All these patients had vitritis.
CONCLUSIONS
Non-selective testing of uveitis patients for Lyme antibodies is not reasonable even in endemic areas. We recommend using the Borrelia antibody test only in cases of uveitis of unknown cause, especially in patients with vitritis or other symptoms of Lyme borreliosis.
目的
评估在莱姆病流行地区对葡萄膜炎患者进行抗伯氏疏螺旋体抗体检测的效用。
方法
我们通过莱姆酶联免疫吸附测定法检测了161例葡萄膜炎患者血清中抗伯氏疏螺旋体的抗体。对病因不明的葡萄膜炎患者以及已确诊患者进行了非选择性抗体检测。
结果
26例（16.1%）葡萄膜炎患者的抗伯氏疏螺旋体抗体浓度升高，其中11例（6.8%）的IgG升高。在这些患者中，有4例因有蜱叮咬史、全身症状、对抗生素治疗的反应和/或聚合酶链反应结果呈阳性，莱姆病是葡萄膜炎的高度疑似病因。排除了葡萄膜炎的其他病因。所有这些患者均有玻璃体炎。
结论
即使在流行地区，对葡萄膜炎患者进行非选择性莱姆抗体检测也是不合理的。我们建议仅在病因不明的葡萄膜炎病例中使用伯氏疏螺旋体抗体检测，尤其是有玻璃体炎或其他莱姆病症状的患者。
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