莱姆病护理初探

莱姆病是林区特有疾病,自1986年发现、认识本病以来,有关护理方面的论述,未见详细报道。现将1986—1992年我院收治200例本病患者护理经验报告如下。 1 隔离 1.1 莱姆病传播媒介主要是蜱,故入院时应注意隔离病人以防将蜱带入院内叮咬他人。注意查找身体各处,特别是耳道、头发等隐蔽处,并设法去除、焚烧,衣物消毒处理。 1.2 莱姆病急性期可从皮肤、脑脊液、血清中分离培养出莱姆病螺旋体。所以护理人     

用免疫印迹法检查40例湖南病人血清莱姆病抗体

用免疫印迹法检查４０例具有某些莱姆病相关症状的病人血清，发现４例血清中同时存在高滴度抗－３１ＫＤａ和抗－４ＫＤａ莱姆病抗原的特异性抗体，占总检查例数的１０％。该４例病人分别被误诊为心肌炎和风湿性关节炎各１例，系统性红斑狼疮２例，无一例诊断为莱姆病。此结果证明湖南存在莱姆病     

用免疫印迹法检查40例湖南病人血清莱姆病抗体

用免疫印迹法检查４０例具有某些莱姆病相关症状的病人血清，发现４例血清中同时存在高滴度抗－３１ＫＤａ和抗－４ＫＤａ莱姆病抗原的特异性抗体，占总检查例数的１０％。该４例病人分别被误诊为心肌炎和风湿性关节炎各１例，系统性红斑狼疮２例，无一例诊断为莱姆病。此结果证明湖南存在莱姆病。     

呼伦贝尔盟林区莱姆病调查

莱姆病是以蜱为传播媒介的一种新的传染病,美国Steere首先报告,现我国有许多地区病例报告。1987年张哲夫证实,我国东北林区存在着莱姆病。为查清我区莱姆病感染状况,1991年春我们在内蒙古呼伦贝尔盟进行此项调查,现报告如下。1 材料和方法血清,在牙克石的绰源和额尔古纳右旗林区,对297个林业工人和当地居民进行访问和检查,同时采静脉血,分离血清放4℃待检。     

盈江县发热病人莱姆病抗体检测报告

采用间接免疫荧光法（ＩＦＡ），对盈江县２０２份发热病人血清进行莱姆病抗体测定，检出阳性２４份，阳性率１１．８８％。调查结果显示盈江县人群存在莱姆病感染。     

莱姆病关节炎型一例报告

莱姆病系全身性感染症，造成人体多系统、多脏器的损害，依据损害程度及症状，临床上可分为早、中、晚三个病期若干个型，本文仅报告晚期莱姆病关节炎型1例。     

安全有效的莱姆病疫苗

两项安慰剂对照试验显示抗博氏疏螺旋体疫苗能有效地预防莱姆病。此试验包括来自美国莱姆病流行地区的21000名受试者。由蜱传播的莱姆病是美国最常见的媒介传播疾病,每年向亚特兰大疾病控制与预防中心报告的新病例约有10000例。此试验用的疫苗由重组博氏疏螺旋体外表面脂蛋白A(OspA)组成。在两项试验中,给受试者注射两次疫苗、两次时间相隔一个月,在第     

新疆那拉提地区菜姆病的实验研讨

菜姆(Lyme)病是近年才认识的一种蜱媒传染病,我国1985年在黑龙江省海林县林区发现该病,为亚洲地区首次发现。笔者在莱姆病自然疫源地新疆那拉提进行了部分实验室工作,其结果报告如下:材料和方法:(一)血清抗体检查:采集病人血液2～3 ml 分离血清,用间接免疫萤光染色法测定病人抗体滴度,凡单位血清 IgG 萤光抗体滴度≥1∶32为可疑,≥1∶64     

太平洋区一些虫媒病的现状

本文介绍了太平洋区7种虫媒病,包括登革热、疟疾、莱姆病、鼠疫、型伤寒、日本乙型脑炎与丝虫。夏威夷最后一例登革热是在1945年。近4年来该病在南太平洋岛屿流行,所以与夏威夷有关。从1984到1990年夏威夷报告有44例输入疟疾病例。因夏威夷没有发现按蚊媒介,所以疟疾并不重要。1989年报告1例因带犬到夏威夷而发生的莱姆病与1例输入的人病例。最后1例鼠疫发生在1947年,但在鼠间持续到1957年。现唯一的虫媒病在夏威夷流行的是鼠型伤寒,从1984到1989年共报告19例病人。在夏威夷从未遇到乙型脑炎,但广泛传播到较大区域的可能性很大。认为丝虫是夏威夷的一种虫媒病,因为有此媒介,历史上在南太平洋群岛也有此病。在WHO虫媒病地理分布(1989)一书中可以发现这7种病的分布现状。     

中国莱姆病研究的新进展

莱姆病(Lyme disease)是一种新发现的蜱传螺旋体感染性人兽共患病。主要经蜱叮咬人、兽而传染。其病原体莱姆病螺旋体(Borrelia burgdorferi)可引起人体多系统、器官的损害,严重者终生致残甚至死亡。该病分布甚广,现已有30多个国家报告发现有     

Role of serology in the diagnosis of Lyme disease.

Numerous concerns regarding the potential for misdiagnosis of Lyme disease using commercial assays have been voiced by the US Food and Drug Administration (FDA). We attempted to clarify the clinical value of serologic testing for Lyme disease using the results of commonly marketed assays for detecting antibody to Borrelia burgdorferi, the organism that causes Lyme disease. We reviewed published studies on B burgdorferi test performance published through 1998, package insert labeling from FDA-cleared test kits for B burgdorferi, and Lyme Disease Survey Set LY-A from the College of American Pathologists. We assessed the sensitivity and specificity of commercial serologic tests (enzyme-linked immunosorbent assay [ELISA], immunofluorescence antibody [IFA], and immunodot) for diagnosis of Lyme disease. To reduce this risk of misdiagnosis, it is important that clinicians understand the performance characteristics and limitations of these tests. These tests, in common use in clinical or commercial laboratories, should be used only to support a clinical diagnosis of Lyme disease, not as the primary basis for making diagnostic or treatment decisions. Serologic testing is not useful early in the course of Lyme disease because of the low sensitivity of tests in early disease. Serologic testing may be more useful in later disease, at which time sensitivity and specificity of the test are improved. Positive or equivocal results on an ELISA, IFA, or immunodot assay requires supplemental testing with a Western blot assay. A negative result on the Western blot or ELISA indicates that there is no serologic evidence of infection by B burgdorferi at the time the sample was drawn.     

中国莱姆病螺旋体PD_(91)重组外膜蛋白C抗原性初步研究

目的　研究中国莱姆病螺旋体 PD91 重组外膜蛋白 C(r Osp C)检测莱姆病特异性抗体Ig M的效果 ,为莱姆病的早期特异性诊断提供依据。方法　 r Osp C经纯化、定量后 ,用于酶联免疫吸附试验 (EL ISA) ,检测早期莱姆病患者和莱姆病疫区工人血清 Ig M,并与其他检测方法比较检测效果。结果　用 r Osp C EL ISA和全菌蛋白 Western blotting方法检测了 12例早期莱姆病患者血清 Ig M,其阳性率分别为 75 %和 6 6 .7% (P>0 .0 5 ) ;r Osp C EL ISA、全菌蛋白 EL ISA检测 98份健康人血清 Ig M,特异度分别为 10 0 %和 96 .94 % (P>0 .0 5 ) ;用 r Osp C EL ISA、全菌蛋白 EL ISA和 IFA检测 2 10例莱姆病疫区工人血清 ,其阳性率分别为 5 .2 4 %、8.5 7%和 7.6 2 % ,3种检测方法间无统计学差异 (P>0 .0 5 )。结论　 r Osp C具有较好的灵敏度和特异性 ,其用于我国早期莱姆病患者的临床检测和莱姆病流行病学调查上有一定的应用价值。     

莱姆病21例的临床特征与转归

回顾性分析北京协和医院1994年4月至2008年1月诊断为莱姆病的21例住院患者的临床表现、实验室检查、治疗及转归。其中临床表现为发热16例（76％）,皮肤损害14例（67％）,神经系统症状17例（81％）,关节表现10例（48％）,心脏受累2例（10％）。使用的治疗药物包括青霉素、头孢曲松、多西环素。21例患者均临床好转出院,有12例（57％）随访1个月～12年,其中2例（17％）Ⅲ期莱姆病患者出现过复发,8例有慢性遗留症状。这说明莱姆病临床表现复杂,对临床疑似病例及时进行病原检测,有利于早诊断。     

Lyme disease: report of two cases

Lyme disease is a tick-borne multisystem disease. It was first described in Lyme, Connecticut, USA in 1975. Cases have been reported in Canada, Switzerland, Austria, Australia and Great Britain. It is an inflammatory disease that has varied clinical manifestations ranging from skin rash (erythema migrans), arthritis, fibromyalgia, and regional lymphadenopathy, cardiac conduction defects to neurological manifestations of meningoencephalitis, Bell's palsy, peripheral neuropathy, and painful radiculoneuropathy. There has been no case record of Lyme disease in Kenya and indeed literature on Lyme disease in Africa is very scanty. We present two cases of Lyme disease with predominant neurological manifestations; outline their clinical presentation and management.     

Lyme病皮肤慢性游走性红斑患者临床,血清学及病理学观察

24例患者均在蜱咬后出现皮肤慢性游走性红斑,其中16例伴淋巴结大、头痛、发热及项强。用ELISA法测定24例患者血清抗BB抗体水平,20例IgM—抗BB抗体阳性;11例IgG—抗BB抗体阳性;两种抗体总阳性率达91.67％。7例皮肤红斑标本病理检查呈急性非特异性渗出性炎症。提示血清抗BB抗体测定是诊断LD的一种敏感和特异的方法。     

Lyme disease during pregnancy

Lyme disease is an increasingly recognized tick-borne illness caused by a spirochete, Borrelia burgdorferi. Because the etiologic agent of Lyme disease is a spirochete, there has been concern about the effect of maternal Lyme disease on pregnancy outcome. We reviewed cases of Lyme disease in pregnant women who were identified before knowledge of the pregnancy outcomes. Nineteen cases were identified with onset between 1976 and 1984. Eight of the women were affected during the first trimester, seven during the second trimester, and two during the third trimester; in two, the trimester of onset was unknown. Thirteen received appropriate antibiotic therapy for Lyme disease. Of the 19 pregnancies, five had adverse outcomes, including syndactyly, cortical blindness, intrauterine fetal death, prematurity, and rash in the newborn. Adverse outcomes occurred in cases with infection during each of the trimesters. Although B burgdorferi could not be implicated directly in any of the adverse outcomes, the frequency of such outcomes warrants further surveillance and studies of pregnant women with Lyme disease.     

Toll样受体和趋化因子与莱姆关节炎发病的相关性

莱姆病是一种由伯氏疏螺旋体引起,经蜱传播的自然疫源性疾病,也是一种人兽共患病,莱姆关节炎是莱姆病的晚期临床表现,严重者可终生致残,严重影响了人们的健康和生活质量,目前,对莱姆关节炎的致病机制尚不清楚,国内外已经取得了一系列进展,但有待进一步研究.现就Toll样受体和趋化因子与莱姆关节炎发病关系的研究做一综述.