海南省2311例关节炎症状患者的莱姆病抗体血清学研究  

Serological study of Lyme disease antibody in 2311 patients with arthritis symptoms in Hainan Province

作　　者：何吕芬 侯学霞[2] 陈婷[1] 张琳[2] 文书 苗广青 邢楣 郝琴[2] 朱雄[1] He Lüfen;Hou Xuexia;Chen Ting;Zhang Lin;Wen Shu;Miao Guangqing;Xing Mei;Hao Qin;Zhu Xiong(Department of Central Laboratory,People′s Hospital of Sanya,Sanya 572000,China;State Key Laboratory for Infectious Disease Prevention and Control,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Department of Clinical Laboratory,People′s Hospital of Qiongzhong County,Qiongzhong 572900,China;Department of Clinical Laboratory,People′s Hospital of Wenchang City,Wenchang 571300,China)

机构地区：[1]海南省三亚市人民医院中心实验室,三亚572000 [2]中国疾病预防控制中心传染病预防控制所,传染病预防控制国家重点实验室,北京102206 [3]海南省琼中县人民医院检验科,琼中572900 [4]海南省文昌市人民医院检验科,文昌571300

出　　处：《中华预防医学杂志》2021年第3期379-385,共7页Chinese Journal of Preventive Medicine

基　　金：海南省重点研发计划项目课题基金项目(ZDYF2017163);海南省卫计行业科研项目(16A200051,19A200039);“十三五”国家科技重大专项(2018ZX10714-002)。

摘　　要：目的探讨海南省关节炎症状患者的莱姆病感染状况,为莱姆病的防控提供依据。方法采用抽样调查方法,2013至2018年在海南省8个市(县)(海口市、三亚市、儋州市、东方市、文昌市、琼海市、琼中县、五指山市)的医疗机构,对其进行抽样调查,收集2 311例关节炎症状就诊的患者血清标本,并对临床资料进行描述性研究。采用间接免疫荧光法(IFA)对血清标本进行莱姆病抗体初筛检测,并采用免疫印迹法(WB)对IFA检测阳性的血清标本进行确诊实验。采用χ^(2)检验进行统计分析。结果 IFA方法检测血清样本2 311份,166份阳性,阳性率7.18%。进一步用 WB方法确认,62份阳性, 莱姆病抗体阳性率为2.68%(62/2 311)。海南省不同地区关节炎症状患者的莱姆病抗体阳性率差异有统计学意义(χ^(2)=40.636,P<0.001),琼中县阳性率最高,为8.81%(14/159);儋州市阳性率次之,为5.62%(5/89);东方市阳性率最低,为0.51%(2/394)。莱姆病血清抗体阳性率男性及女性分别是2.79%(33/1 182)和2.57%(29/1 129);各年龄组间的抗体阳性率在1.74%~3.64%,在性别和年龄间差异无统计学意义(χ^(2)=0.110,P=0.740;χ^(2)=1.938,P=0.747)。结论海南省8个市(县)均存在伯氏疏螺旋体感染导致的关节炎症状患者,但莱姆病抗体阳性率各市(县)存在差异,以琼中县最高。Objective To understand the infectious status of Lyme disease among patients with arthritis symptoms in Hainan Province,and to provide a theoretical basis for prevention and control of Lyme disease.Methods From 2013 to 2018,sampling surveys had been conducted in medical institutions in 8 cities in Hainan Province(Haikou,Sanya,Danzhou,Dongfang,Wenchang,Qionghai,Qiongzhong,Wuzhishan),2311 patients serum samples were collected with arthritis symptoms,and descriptive research were conducted base on the collected clinical data.The Indirect Fluorescent-Antibody Test(IFA)method was used for preliminary screening of Lyme disease antibody,the Western Blot(WB)method was used for IFA positive samples confirmation.Statistical analysis usingχ^(2) test.Results 2311 serum samples were tested by IFA,and 166 were positive with the positive rate of 7.18%.Further confirmed by WB method,62 samples were positive,the positive rate of Lyme disease antibody was 2.68%(62/2311).The positive rate of Lyme disease antibody among patients with arthritis in different regions of Hainan was statistically significant(χ^(2)=40.636,P<0.001),and the positive rate in Qiongzhong city was the highest(8.81%,14/159).Danzhou′s positive rate was the second highest,5.62%(5/89).Dongfang city had the lowest positive rate(0.51%,2/394).The positive rates of Lyme disease serum antibody in men and women were 2.79%(33/1182)and 2.57%(29/1129),respectively;the positive rates of antibodies between each age groups were in the range of 1.74%to 3.64%.The antibody positive rate of Lyme disease showed no significant difference between gender and age(χ^(2)=0.110,P=0.740;χ^(2)=1.938,P=0.747).Conclusion Patients with arthritis symptoms caused by Borrelia burgdorferi infection were found in 8 cities in Hainan province,but the Lyme disease antibody positive rate was different among cities,with Qiongzhong County being the highest.

关 键 词：莱姆病 血清标本 抗体检测 关节炎症状 

分 类 号：R684.3[医药卫生—骨科学] R514.4[医药卫生—外科学]