以神经系统表的现为主的莱姆病17例临床分析.pdf

医学临床研究 　2003 年 11 月 　第 20 卷 　第 11 期 　J Clin Res , Nov . 2003 , Vol 20 , №11 ·83 1 · ·论著 · 以神经系统表现为主的莱姆病 17 例临床分析 陆敬民 (徐州医学院附属淮安医院 ,江苏 　淮安 　223002) 　　[摘要] 目的 分析莱姆病的神经系统表现及其诊断和治疗 。 方法 对 17 例莱姆病患者的神经系统表 现及辅助检查结果进行回顾性分析 。 结果 莱姆病的神经系统表现复杂 , 以中枢神经和周围神经损害的表现 为主 。血和脑脊液伯氏疏螺旋体抗体滴度为 1 ∶64～1 ∶500 。 结论 莱姆病的神经系统表现无特异性 ,早期诊 断难 ,根据临床表现 、流行病学资料和抗体检查可协助诊断 ,治疗以抗生素为主 。 　　[ 关键词] 　莱姆病 Cl inical Analysis of 17 Cases with Lyme Disease Displaying mainly Neurological Manif estations 　　　L U J ingm in ( Dep art ment of N eu rology , The Af f iliated H uaian Hosp ital of X uz hou M edical College , H uaian 223002 , J iangs u , China ) 　　[ Abstract] Obj ectives To analyze t he neurological manifestations of L yme disease (LD) as well as it s diagnosis and treat ment . Met hods The neurological manifestations and result s of auxiliary examination in 17 LD p atient s were analyzed retrosp ectively . Result s Neurological manifestations of LD were considerably complicated ; bot h cen tral and p erip heral nerve systems were mainly involved in t hese cases. An elevated antibody titer against Borrelia burgdorferi ( 1 ∶64～1 ∶500) was found in serum and cerebrospinal fluid ( CSF) . Conclusion It is difficult to make early diagnosis of LD , for it s neurological manifestations are usually nonsp ecific . Clinical symptoms , epidemiological data and antibody detection can help t he diagnosis ; while antibiotics are t he chief measure of treat ment . 　　[ Key words] 　lyme disease ( ) [ 中图分类号] 　R5 14 　[文献标识码] 　A 　[文章编号] 　167 17 17 1 2003 11083 103 ( ) ( ) 　　莱姆病 L yme disease 是通过硬蜱传播的伯 氏 年龄 35 14 ～50 岁 。病程 6 d 至 60 个月 ,平均 14