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目的探讨临床使用抗生素治疗不同类型、不同阶段莱姆病患者的效果,观查治疗前后莱姆抗体滴度的变化及其对临床转归的意义。方法对确诊的42例不同类型、不同阶段莱姆病患者使用抗生素治疗,治疗前后采用间接免疫荧光试验(IFA)、蛋白印迹试验(WB)方法,检测患者血清和脑脊液(CSF)中抗伯氏疏螺旋体IgM、IgG抗体。以自身对照方法,观测治疗后临床转归和抗伯氏疏螺旋体抗体滴度的动态变化。结果使用抗生素治疗早期局限性病变和急性神经系统病变患者,临床可治愈或好转,总有效率为83.33%。治疗一年后患者血清学反应转阴者32例。晚期中枢神经系统发生实质性受累者治疗效果不佳,血清及CSF抗体滴度变化均不明显。结论早期确诊对患者的治疗至关重要。治疗越早,效果越好,抗体滴度的变化可作为临床疗效的佐证之一。晚期中枢神经系统实质性受累者,难以治愈。
Objective To investigate the clinical effect of antibiotics on different types and stages of Lyme disease patients and to observe the changes of Lyme antibody titers before and after treatment and their clinical significance. Methods 42 patients with different types and stages of Lyme disease were treated with antibiotics. IFA and WB were used before and after treatment to detect anti-berberine in serum and cerebrospinal fluid (CSF) Borrelia IgM, IgG antibody. The self-control method was used to observe the clinical outcome after treatment and the dynamic changes of anti-Borrelia burgdorferi antibody titers. Results The use of antibiotics in the treatment of patients with early localized lesions and acute neurological diseases was clinically curable or improved with a total effective rate of 83.33%. Thirty-two patients were seronegative after one year of treatment. Treatment of patients with advanced central nervous system involvement was poor, and serum and CSF antibody titers did not change significantly. Conclusion Early diagnosis of patients is crucial for the treatment. The sooner the treatment is, the better the effect is. The change of the antibody titer can be used as an evidence of clinical efficacy. Patients with advanced central nervous system involvement are difficult to cure.