Pediatric Lyme disease: systematic assessment of post-treatment symptoms and quality of life.
Pediatric Lyme disease: systematic assessment of post-treatment symptoms and quality of life.
复制标题
儿科莱姆病：治疗后症状和生活质量的系统评估。
DOI：
10.1038/s41390-023-02577-3
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发表时间：
2023
影响因子：
3.6
通讯作者：
DeBiasi,RobertaL
中科院分区：
文献类型：
--
作者：
Monaghan,Maureen;Norman,Stephanie;Gierdalski,Marcin;Marques,Adriana;Bost,JamesE;DeBiasi,RobertaL
研究背景莱姆病在儿童和青少年中很常见。抗生素治疗是有效的，但有些患者报告治疗后持续的症状，有或没有功能障碍。本研究的特点与莱姆病的儿科患者的长期结果和评估治疗后莱姆病（PTLD）syndrome.MethodsThe样本包括102例确诊莱姆病6个月-10年前登记（M = 2.0年）的儿童的情况下定义。莱姆病诊断和治疗信息从电子健康记录中提取;父母报告确定了治疗后症状的存在、持续时间和影响。参与者完成了有效的问卷调查，评估健康相关的生活质量，身体流动性，疲劳，疼痛和认知impacts.ResultsMost父母报告说，他们的孩子的症状完全解决，虽然时间完全解决各不相同。22名父母（22%）表示他们的孩子在治疗后至少有一种持续症状>6个月，13名没有功能障碍（PTLD症状），9名有功能障碍（PTLD综合征）。PTLD综合征的儿童有较低的父母报告的物理总结分数和更大的可能性升高fatigue.ConclusionsIn目前的研究，大多数儿童莱姆病经历了完全解决的症状，包括那些最初符合PTLD综合征标准。对治疗后可能持续存在的恢复率和常见症状进行有效的沟通是必要的。影响大多数接受莱姆病各阶段治疗的儿科患者报告在6个月内症状完全消退。22%的儿科患者报告一种或多种症状持续>6个月，9%伴有和13%不伴有功能障碍。与家属就康复率和术后可能持续存在的常见症状进行有效沟通。需要治疗莱姆病。
BackgroundLyme disease is common among children and adolescents. Antibiotic treatment is effective, yet some patients report persistent symptoms following treatment, with or without functional impairment. This study characterized long-term outcome of pediatric patients with Lyme disease and evaluated the case definition of post-treatment Lyme disease (PTLD) syndrome.MethodsThe sample included 102 children with confirmed Lyme disease diagnosed 6 months—10 years prior to enrollment (M = 2.0 years). Lyme diagnosis and treatment information was extracted from the electronic health record; parent report identified presence, duration, and impact of symptoms after treatment. Participants completed validated questionnaires assessing health-related quality of life, physical mobility, fatigue, pain, and cognitive impact.ResultsMost parents reported their child’s symptoms resolved completely, although time to full resolution varied. Twenty-two parents (22%) indicated their child had at least one persistent symptom >6 months post-treatment, 13 without functional impairment (PTLD symptoms) and 9 with functional impairment (PTLD syndrome). Children with PTLD syndrome had lower parent-reported Physical Summary scores and greater likelihood of elevated fatigue.ConclusionsIn the current study, most children with Lyme disease experienced full resolution of symptoms, including those who initially met PTLD syndrome criteria. Effective communication about recovery rates and common symptoms that may persist post-treatment is needed.ImpactThe majority of pediatric patients treated for all stages of Lyme disease reported full resolution of symptoms within 6 months.22% of pediatric patients reported one or more symptom persisting >6 months, 9% with and 13% without accompanying functional impairment.Effective communication with families about recovery rates and common symptoms that may persist post-treatment of Lyme disease is needed.