目的 对山西省首例拟诊莱姆病患者进行血清学检测和结果分析,为证实山西省存在莱姆病典型病例提供科学依据,同时加深医务工作者对莱姆病的认识,提高临床医师对该病的诊治水平。方法 应用间接免疫荧光试验(IFA)和蛋白免疫印迹(WB)2种方法,对此例患者进行血清抗伯氏疏螺旋体IgM和IgG抗体检查,并结合临床症状进行综合分析。结果 第1份血清标本检测结果显示,IFA和WB两种试验方法IgM均为阳性,其中IFA的IgM抗体滴度达到1∶64,WB的IgM有2条蛋白带P41和P31;2种试验方法IgG均为阴性。间隔半个月后的第2份血清检测结果显示,2种试验方法IgG均为阳性,其中IFA的IgG抗体滴度达到1∶256,WB的IgG有2条蛋白带P41和P31,2种试验方法IgM均为阴性。结论 患者临床表现和病程发展符合莱姆病的特征,实验室检测结果阳性,莱姆病的诊断成立,证实山西省存在莱姆病典型病例。
Objective To provide a scientific basis for confirmation of typical Lyme disease by serological analysis of the first suspected case of Lyme disease in Shanxi province, China and to improve the clinicians’recognition of Lyme disease for prompt diagnosis and treatment. Methods Using indirect immunofluorescence assay (IFA) and Western blot (WB), the patient suspected of Lyme disease was tested for anti-Borrelia burgdorferiIgM and IgG antibodies. A comprehensive analysis was conducted given clinical symptoms. Tests were repeated half a month later. Results In the first test, IgM antibodies were detected by IFA and WB. The titer of IgM antibodies was1∶64 in IFA, and two protein bands, P41 and P31, were present in WB.IgG antibodies were not found by any of the two tests. In the second test half a month later, IgG antibodies were positive in both IFA and WB. The titer of IgG antibodies went up to1∶256 in IFA, and two protein bands, P41 and P31, were present in WB. IgM antibodies were not found by any of the two approaches.Conclusion Based on the clinical history and progression of disease, as well as the serological results of this research, the diagnosis of Lyme disease can be confirmed, indicating the existence of typical Lyme disease in Shanxi province.
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