Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?
Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?
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DOI：
10.1007/s11136-012-0126-6
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发表时间：
2013-02
影响因子：
3.5
通讯作者：
Kortte, Kathleen B.
中科院分区：
文献类型：
--
作者：
Aucott, John N.;Rebman, Alison W.;Crowder, Lauren A.;Kortte, Kathleen B.
部分接受莱姆病治疗的患者报告持续或反复出现不明原因的症状，称为治疗后莱姆病综合征(PTLDS)。这项研究旨在描述一组早期未经治疗的莱姆病患者，并描述治疗后的症状和PTLDS随时间的功能影响。63名有红斑、迁徙和全身症状的参与者参加了一项前瞻性队列研究。参与者接受了体检和临床评估，并在为期6个月的5次访问中完成了SF-36(日常生活功能)和Beck抑郁量表第二版(BDI-II)(抑郁症)。莱姆病的症状在治疗后消失；然而，新发病的患者报告的症状随着时间的推移而增加或停滞。6个月后，36%的患者报告出现新的疲劳，20%的患者出现广泛疼痛，45%的患者出现神经认知障碍。然而，在整个过程中，只有不到10%的人报告说自己的抑郁程度超过了“最低限度”。在人口统计学、治疗前SF-36和BDI-II得分方面，患有PTLDS的患者(36%)与没有PTLDS的患者没有显著差异。随着时间的推移，在那些最终被诊断为PTLDS的人和那些没有被诊断为PTLDS的人之间，随着时间的推移，在SF-36的角色、活力、社会功能、角色情绪和精神健康子量表(其余三个子量表的身体功能、身体疼痛和一般健康)上有显著的差异。与莱姆病的临床症状不同，新出现的症状是由一小部分参与者报告的，没有抑郁症状的证据。与无PTLDS的患者相比，发生PTLDS的患者的生活功能显著降低。我们提出了未来研究由多种机制引起的感染触发症状的途径。
A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time. Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months. Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than “minimal” depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months. Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.
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DOI：
10.1002/art.24314
发表时间：
2008-12-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Hassett, Afton L.;Radvanski, Diane C.;Sigal, Leonard H.
通讯作者：
Sigal, Leonard H.
影响因子：
6.4
作者：
Kalish, RA;Kaplan, RF;Steere, AC
通讯作者：
Steere, AC
影响因子：
9.9
作者：
KAPLAN, RF;MEADOWS, ME;STEERE, AC
通讯作者：
STEERE, AC
影响因子：
9.4
作者：
Liveris, Dionysios;Schwartz, Ira;Wormser, Gary P.
通讯作者：
Wormser, Gary P.
影响因子：
158.5
作者：
LOGIGIAN, EL;KAPLAN, RF;STEERE, AC
通讯作者：
STEERE, AC