海南省东北部地区某类就诊患者莱姆病抗体检测结果分析  

Test results for detection of antibody against Lyme disease in certain patients in the northeast of Hainan province

作　　者：李沙 张琳[2] 李欢 侯学霞[2] 陈婷 苗广青 符晓莹 陈海 郝琴[2] 朱雄 LI Sha;ZHANG Lin;LI Huan;HOU Xue-xia;CHEN Ting;MIAO Guang-qing;FU Xiao-ying;CHEN Hai;HAO Qin;ZHU Xiong(The People's Hospital of Sanya City,Sanya,Hainan 572000,China;National Institute for Communicable Disease Control and Preventioni Chinese Center for Disease Control and Prevenlioni Beijing 102206,China)

机构地区：[1]三亚市人民医院,海南三亚572000 [2]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《实用预防医学》2020年第9期1068-1071,共4页Practical Preventive Medicine

基　　金：海南省重点研发项目(ZDYF2017163);十三五重大专项(2018ZX10714-002-001);海南省医药卫生科研项目(16A200051)。

摘　　要：目的了解海南省东北部地区人群莱姆病感染状况,为临床医生诊断莱姆病提供参考,为本省莱姆病的流行病学调查提供可靠的理论依据。方法收集海南省东北部地区三家医院1 334例有关节症状和(或)神经症状的患者血清,采用两步法检测莱姆病抗体,使用间接免疫荧光法(indirect fluorescent antibody test,IFA)初筛血清,对IFA检测阳性血清用免疫印迹法(Western blot,WB)确证。结果 IFA法筛查海南省东北部地区1 334例患者莱姆病抗体阳性60例,阳性率4.50%。海口、文昌和琼海地区的三家医院该类就诊患者莱姆病抗体阳性率分别为4.25%、1.40%和8.28%(IFA)。三家医院阳性率比较差异有统计学意义(χ~2=25.640,P<0.05)。按不同性别、年龄分组海南省东北部地区三家医院莱姆病抗体阳性率比较差异均无统计学意义(χ~2=2.306,P>0.05;χ~2=1.015,P>0.05)。WB法确证莱姆病抗体阳性28例,其抗体以31 KD的外膜蛋白A、33 KD-36 KD外膜蛋白B、39 KD膜脂蛋白、41 KD鞭毛蛋白和60 KD热休克蛋白抗体为主。结论海南省东北部地区存在人群感染莱姆病,应加强当地疾病预防和监测。Objective To investigate the prevalence of Lyme disease among people in the northeast of Hainan province so as to provide references for clinicians’ diagnosis and a reliable theoretical basis for epidemiological investigation of Lyme disease in Hainan province. Methods We collected 1,334 serum samples from patients with arthritis and/or neurological symptoms in three hospitals in the northeast of Hainan province. Firstly, indirect fluorescent antibody(IFA) test was used to detect serum antibodies against Lyme disease, and secondly, the positive samples detected by IFA test were confirmed by Western blot(WB) test. Results Among the 1,334 patients detected by IFA test in the northeast of Hainan province, 60 cases were positive for antibodies against Lyme disease, and the positive rate was 4.50%. The positive rates of Lyme disease antibodies detected by IFA in the 1,334 patients from the three hospitals in Haikou, Wenchang and Qionghai were 4.25%, 1.40% and 8.28%, respectively, showing statistically significant differences among the three hospitals(χ~2=25.640, P<0.05). No statistically significant differences were found in the positive rates of antibodies to Lyme disease between different genders and among age groups(χ~2=2.306, P>0.05;χ~2=1.015, P>0.05). WB test showed that 28 cases were confirmed to be positive for antibodies to Lyme disease, which mainly included 31 KD outer surface protein A, 33 KD-36 KD outer surface protein B, 39 KD Borrelia burgdorferi membrane protein A, 41 KD flagellin and 60 KD heat shock protein. Conclusions There exists Lyme disease infection among people in the northeast of Hainan province;and hence, local disease prevention and surveillance should be strengthened.

关 键 词：莱姆病 血清抗体 抗体检测 

分 类 号：R514[医药卫生—内科学]