Neuroborreliosis-an epidemiological, clinical and healthcare cost study from an endemic area in the south-east of Sweden
Neuroborreliosis-an epidemiological, clinical and healthcare cost study from an endemic area in the south-east of Sweden
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DOI：
10.1111/j.1469-0691.2009.03059.x
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发表时间：
2010-08-01
影响因子：
14.2
通讯作者：
Forsberg, P.
中科院分区：
文献类型：
--
作者：
Henningsson, A. J.;Malmvall, B. -E.;Forsberg, P.
我们回顾性研究了2000-2005年瑞典延雪平县所有经脑脊液（CSF）分析诊断为神经型疏螺旋体病（NB）的患者（n = 150）的病历。NB病例数从5/100 000居民/年增加到10/100 000居民/年。在17%的患者中，在诊断时在CSF中发现抗疏螺旋体抗体，但在血清中未发现。面瘫、头痛和发热是儿童的常见表现，而非特异性肌肉和关节疼痛是老年患者最常见的症状。治疗后症状持续超过6个月的发生率为13%，相关患者年龄明显较大，治疗前症状持续时间较长，CSF中疏螺旋体特异性IgG水平较高，并且更常发生神经根炎。整个研究组与NB相关的医疗保健总费用估计为500 000欧元（每位患者3300欧元），社会福利费用估计为134 000欧元（每位患者2000欧元）。脑脊液分析对于NB的诊断是必要的，因为一些患者在血清中产生抗体晚于在脑脊液中产生抗体。疏螺旋体病的早期诊断将导致减少人类痛苦和经济收益。
P>We studied retrospectively the medical records of all patients (n = 150) diagnosed, by cerebrospinal fluid (CSF) analysis, with neuroborreliosis (NB) in Jonkoping County, Sweden during 2000-2005. The number of NB cases increased from 5/100 000 to 10/100 000 inhabitants/year. In 17% of the patients, anti-Borrelia antibodies were found in CSF but not in serum at the time of diagnosis. Facial palsy, headache and fever were frequent manifestations in children, whereas unspecific muscle and joint pain were the most commonly reported symptoms in older patients. Post-treatment symptoms persisting for more than 6 months occurred in 13%, and the patients concerned were significantly older, had longer-lasting symptoms prior to treatment, had higher levels of Borrelia-specific IgG in CSF, and more often had radiculitis. The total cost of NB-related healthcare was estimated to be euro500 000 for the entire study group (euro3300 per patient), and the cost of social benefits was estimated to be euro134 000 (euro2000 per patient). CSF analysis is necessary for the diagnosis of NB, because some patients develop antibodies in serum later than in CSF. Early diagnosis of borreliosis would result in reduced human suffering and in economic gain.