{"id":63298,"date":"2018-11-15T01:00:00","date_gmt":"2018-12-07T03:26:17","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/2018\/12\/07\/94a9b699f0\/"},"modified":"2018-12-07T11:26:22","modified_gmt":"2018-12-07T03:26:22","slug":"94a9b699f0","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/63298\/","title":{"rendered":"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9"},"content":{"rendered":"
\n

\u83b1\u59c6\u75c5\u662f\u4e00\u79cd\u4ee5\u8731\u4e3a\u5a92\u4ecb\u7684\u87ba\u65cb\u4f53\u611f\u67d3\u6027\u75be\u75c5\uff0c\u662f\u7531\u4f2f\u6c0f\u758f\u87ba\u65cb\u4f53\uff08Borrelia Burgdorferi\uff0cBb\uff09\u6240\u81f4\u7684\u81ea\u7136\u75ab\u6e90\u6027\u75be\u75c5\u3002
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<\/p>\n

\u636e\u62a5\u9053\uff0c10%-15% \u7684\u758f\u87ba\u65cb\u4f53\u75c5\u60a3\u8005\u7d2f\u53ca\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u5bfc\u81f4\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\uff08Lyme neuroborreliosis\uff0cLNB\uff09\u3002\u672c\u6587\u5c06\u5bf9 LNB \u7684\u8bca\u65ad\u6807\u51c6\u8fdb\u884c\u9610\u8ff0\uff0c\u5e76\u5c06\u5bf9 LNB \u7684\u5f71\u50cf\u5b66\u8868\u73b0\u8fdb\u884c\u8be6\u7ec6\u4ecb\u7ecd\u3002<\/p>\n

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\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u4e34\u5e8a\u8868\u73b0<\/strong><\/p>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

LNB \u7684\u4e34\u5e8a\u8868\u73b0\u5728\u4e0d\u540c\u4e2a\u4f53\u95f4\u5177\u6709\u660e\u663e\u4e34\u5e8a\u5f02\u8d28\u6027\u3002\u76ae\u80a4\u9996\u5148\u53d7\u5230\u5f71\u54cd\uff0c\u5e76\u53ef\u4ee5\u89c2\u5bdf\u5230\u6e38\u8d70\u6027\u7ea2\u6591\u3002\u7ea6\u6709 1\/3-1\/2 \u7684\u60a3\u8005\u80fd\u56de\u5fc6\u8d77\u8731\u53ee\u54ac\u53f2\u6216\u76ae\u75b9\u75c5\u53f2\u3002
<\/p>\n


<\/p>\n

\u6210\u4eba LNB \u6700\u5e38\u89c1\u7684\u795e\u7ecf\u8868\u73b0\u4e3a Bannwarth \u7efc\u5408\u5f81\uff0c\u4f34\u6709\u75db\u6027\u611f\u89c9\u6027\u795e\u7ecf\u6839\u708e\u548c\u65e0\u83cc\u6027\u8111\u819c\u708e\uff0c\u5176\u6b21\u4e3a\u9762\u795e\u7ecf\u9ebb\u75f9\u3002\u8f83\u5c11\u89c1\u7684\u795e\u7ecf\u7cfb\u7edf\u8868\u73b0\u4e3a\u8111\u819c\u8111\u708e\u3001\u8111\u810a\u9ad3\u708e\u3001\u8111\u8840\u7ba1\u708e\u548c\u5468\u56f4\u795e\u7ecf\u75c5\u53d8\u3002LNB \u5f88\u5c11\u7531\u4e8e\u9885\u5185\u538b\u5347\u9ad8\u51fa\u73b0\u89c6\u795e\u7ecf\u75c5\u53d8\u548c\u89c6\u4e73\u7a81\u6c34\u80bf\u3002<\/p>\n


<\/p>\n

\u65e9\u671f\u548c\u665a\u671f LNB \u662f\u4ee5\u795e\u7ecf\u7cfb\u7edf\u75c7\u72b6\u6301\u7eed\u65f6\u95f4\u662f\u5426\u8d85\u8fc7 6 \u4e2a\u6708\u6765\u533a\u5206\u7684\uff0c\u8d85\u8fc7 95% \u7684\u75c5\u4f8b\u88ab\u5f52\u7c7b\u4e3a\u65e9\u671f\u75be\u75c5\u3002\u5927\u591a\u6570\u83b1\u59c6\u75c5\u60a3\u8005\u5bf9\u6297\u751f\u7d20\u6cbb\u7597\u53cd\u5e94\u826f\u597d\uff0c\u4f46\u90e8\u5206\u60a3\u8005\u4f1a\u9057\u7559\u6301\u7eed\u7684\u5e76\u53d1\u75c7\u3002<\/p>\n

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\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u8bca\u65ad\u6807\u51c6<\/strong><\/p>\n<\/section>\n<\/section>\n

\n
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<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u6b27\u6d32\u795e\u7ecf\u75c5\u5b66\u8054\u76df\uff08EFNS\uff09\u4e8e 2010 \u5e74\u5236\u5b9a\u4e86 LNB \u8bca\u65ad\u6307\u5357<\/p>\n


<\/p>\n

\u8868 1. LNB \u7684 EFNS \u8bca\u65ad\u6807\u51c6<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
a \u8fd9\u4e9b\u6807\u51c6\u9002\u7528\u4e8e LNB \u7684\u6240\u6709\u4e9a\u7c7b\uff0c\u9664\u4e86\u5177\u6709\u591a\u53d1\u6027\u795e\u7ecf\u75c5\u7684\u665a\u671f LNB\uff0c\u5e94\u6ee1\u8db3\u4ee5\u4e0b\u6807\u51c6\uff1a\uff08I\uff09\u5468\u56f4\u795e\u7ecf\u75c5\uff08II\uff09\u6162\u6027\u840e\u7f29\u6027\u76ae\u708e\uff08III\uff09\u8840\u6e05\u4e2d\u7684 Bb \u7279\u5f02\u6027\u6297\u4f53\u3002b \u5982\u679c\u7f3a\u4e4f\u6807\u51c6 3\uff09\uff0c6 \u5468\u540e\uff0c\u9700\u8981\u8840\u6e05\u4e2d\u53d1\u73b0 Bb \u7279\u5f02\u6027 IgG \u6297\u4f53\u3002<\/span><\/p>\n


<\/p>\n

\u7531\u4e8e IgM \u548c IgG \u6297\u4f53\u5728\u611f\u67d3\u540e\u51e0\u5e74\u4ecd\u53ef\u4fdd\u6301\u9633\u6027\uff0c\u56e0\u6b64\u7ed3\u679c\u53ef\u80fd\u65e0\u6cd5\u533a\u5206\u75c5\u6bd2\u524d\u66b4\u9732\u3001\u518d\u611f\u67d3\u6216\u6025\u6027\u611f\u67d3\u3002<\/p>\n


<\/p>\n

\u7f8e\u56fd\u795e\u7ecf\u75c5\u5b66\u5b66\u4f1a\uff08AAN\uff09\u7684\u8bca\u65ad\u6807\u51c6\u5e76\u4e0d\u5305\u62ec\u8111\u810a\u6db2\u5206\u6790\uff0c\u4f46\u6709\u4e00\u4e2a\u6216\u591a\u4e2a\u79fb\u884c\u6027\u7ea2\u6591\uff0c\u53ef\u901a\u8fc7\u7ec4\u7ec7\u75c5\u7406\u5b66\u3001\u5fae\u751f\u7269\u5b66\u6216\u75c5\u7406\u5b66\u3001\u805a\u5408\u9176\u94fe\u5f0f\u53cd\u5e94\u6216\u514d\u75ab\u5b66\u8bc1\u636e\u76f4\u63a5\u8bc1\u5b9e\u611f\u67d3\u3002<\/p>\n


<\/p>\n

\u7f8e\u56fd\u548c\u6b27\u6d32\u7684 LNB \u8bca\u65ad\u6807\u51c6\u90fd\u5f3a\u8c03\u6392\u9664\u5176\u4ed6\u75be\u75c5\u53ef\u80fd\u3002\u56e0\u6b64\uff0c\u78c1\u5171\u632f\u6210\u50cf\uff08MRI\uff09\u5728 LNB \u7684\u8bca\u65ad<\/strong>\u548c\u968f\u8bbf<\/strong>\u4e2d\u8d77\u7740\u81f3\u5173\u91cd\u8981\u7684\u4f5c\u7528\u3002<\/p>\n

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\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u8868\u73b0<\/strong><\/p>\n<\/section>\n<\/section>\n

\n
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<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u5927\u91cf\u75c5\u4f8b\u62a5\u544a\u63d0\u793a LNB \u5177\u6709\u5e7f\u6cdb\u7684\u5f71\u50cf\u5b66\u8868\u73b0\uff0c\u5305\u62ec\u8111\u6216\u810a\u9ad3\u5f25\u6f2b\u6027\u6216\u80bf\u7624\u6837\u75c5\u53d8\u3001\u8111\u819c\u548c\/\u6216\u795e\u7ecf\u5f3a\u5316\u4ee5\u53ca\u8840\u7ba1\u6027\u75c5\u53d8\uff0c\u5176\u4e2d\u8111\u819c\u548c\uff08\u6216\uff09\u795e\u7ecf\u5f3a\u5316\u6700\u4e3a\u5e38\u89c1\u3002
<\/p>\n


<\/p>\n

 \u8111\u819c\u795e\u7ecf\u6839\u708e <\/span><\/strong><\/span><\/p>\n


<\/p>\n

\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u6700\u5178\u578b\u7684\u8868\u73b0\u662f Bannwarth \u7efc\u5408\u5f81\u4f34\u795e\u7ecf\u6839\u708e\uff0c\u5f15\u8d77\u6839\u6027\u795e\u7ecf\u75db\uff0c\u6709\u65f6\u8fd8\u4f1a\u51fa\u73b0\u80a2\u4f53\u8fdc\u7aef\u6216\u8179\u58c1\u9ebb\u75f9\u3002\u75bc\u75db\u5e38\u4e0e\u591c\u95f4\u52a0\u91cd\uff0c\u4f4d\u7f6e\u548c\u75bc\u75db\u7a0b\u5ea6\u4e5f\u53ef\u80fd\u4f1a\u6709\u53d8\u5316\u3002<\/p>\n


<\/p>\n

19.5%-29% \u7684 LNB \u60a3\u8005\u6709\u8111\u819c\u708e\u7684\u4e34\u5e8a\u8868\u73b0\uff0c\u5f71\u50cf\u5b66\u51fa\u73b0\u8111\u819c\u3001\u9885\u795e\u7ecf\u548c\u810a\u795e\u7ecf\u589e\u5f3a\u3002<\/p>\n


<\/p>\n

\u75c5\u4f8b 1.<\/span><\/strong><\/span> 63 \u5c81\u7537\u60a3\u51fa\u73b0\u4e86\u53cc\u4fa7\u4e0a\u80a2\u529b\u5f31\u3001\u795e\u7ecf\u6839\u6027\u75bc\u75db\u3001\u53d1\u70ed\u548c\u53cd\u5c04\u6d88\u5931 4 \u5468\u3002\u8111\u810a\u6db2\u5206\u6790\u663e\u793a\u86cb\u767d\u5347\u9ad8\uff08243 mg\/dL\uff09\u548c\u6dcb\u5df4\u7ec6\u80de\u589e\u591a\uff08234 \u4e2a\u7ec6\u80de\/\u03bcL\uff09\u3002<\/p>\n


<\/p>\n

\u5f71\u50cf\u5b66\u8868\u73b0\u53f3\u4fa7\u81c2\u4e1b\u795e\u7ecf T2 \u50cf\uff08A\uff09\u663e\u793a\u81c2\u4e1b\u795e\u7ecf\uff08\u7bad\u5934\uff09\uff0cT1 \u589e\u5f3a\uff08B\uff09\u53ef\u89c1\u663e\u8457\u5f3a\u5316\uff0c\u77ed T1 \u53cd\u8f6c\u6062\u590d\u56fe\u50cf\u663e\u793a\u5de6\u81c2\u4e1b\u795e\u7ecf\uff08C\uff09\u589e\u7c97\uff0cT1 \u589e\u5f3a\u663e\u793a\u80cc\u4fa7\uff08\u5927\u7bad\u5934\uff09\u548c\u8179\u4fa7\uff08\u7bad\u5934\uff09\u795e\u7ecf\u6839\u5f3a\u5316\uff08D\uff09\u3002<\/p>\n


<\/p>\n

\u8840\u6e05\u548c\u8111\u810a\u6db2\u4e2d\u83b1\u59c6\u6297\u4f53\u6ef4\u5ea6\u5347\u9ad8\u3002\u4e34\u5e8a\u8bca\u65ad\u4e3a Bannwarth \u7efc\u5408\u5f81\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 1<\/span><\/p>\n


<\/p>\n

\u75c5\u4f8b 2.<\/span><\/strong><\/span> 34 \u5c81\u7537\u6027\uff0c\u8fdb\u884c\u6027\u6b65\u6001\u969c\u788d\u4f34\u62ec\u7ea6\u808c\u529f\u80fd\u969c\u788d 7 \u6708\u4f59\u3002\u67e5\u4f53\u663e\u793a\u75c9\u631b\u548c\u5171\u6d4e\u5931\u8c03\u6027\u622a\u762b\uff0cMRI \u663e\u793a\u5e7f\u6cdb\u7684\u8111\u819c\u810a\u9ad3\u708e\u3002<\/p>\n


<\/p>\n

\u8840\u6e05\u53ca\u8111\u810a\u6db2\u4e2d\u6297\u83b1\u59c6\u75c5 IgG \u6297\u4f53\u9633\u6027\uff0c\u8840\u6e05\u4e2d IgM \u5347\u9ad8\u3002\u8111\u810a\u6db2\u6dcb\u5df4\u7ec6\u80de\u589e\u9ad8\uff08195 \u4e2a\u767d\u7ec6\u80de\/\u03bcL\uff09\u548c\u9798\u5185\u5408\u6210\u6297 Bb IgG \u6297\u4f53\u3002\u5934\u5b62\u66f2\u677e 2 g\/d \u6cbb\u7597 4 \u5468\u540e\u75c5\u60c5\u6709\u660e\u663e\u6539\u5584\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 2.\uff08A-C\uff09T1 \u589e\u5f3a\u663e\u793a\u6cbf\u7740\u6865\u8111\u3001\u8111\u810a\u9ad3\u548c\u810a\u9ad3\u8f6f\u8111\u819c\u5f3a\u5316\u3002FLAIR\uff08D\uff09\u548c T2 \u52a0\u6743\u56fe\u50cf\uff08E\uff09\u663e\u793a\u8111\u810a\u9ad3\uff08D\uff09\u3001\u9888\u9ad3\u7684\u5468\u56f4\u4ee5\u53ca\u8584\u675f\u548c\u6954\u675f\uff08E\uff09\u9ad8\u4fe1\u53f7\u3002\uff08A\uff09\u7684\u7ebf\u4ee3\u8868\u8f74\u5411\u56fe\u50cf\u7684\u4f4d\u7f6e\uff08\u4e0a\u7ebf\uff1aB-d\uff0c\u5e95\u7ebf\uff1aC\u2013E\uff09<\/span><\/p>\n


<\/p>\n

 \u9885\u795e\u7ecf\u708e <\/span><\/strong><\/span><\/p>\n


<\/p>\n

\u7ea6 80% \u7684 LNB \u9885\u795e\u7ecf\u53d7\u7d2f\u5f71\u54cd\u9762\u795e\u7ecf\uff0c\u5176\u4e2d 25% \u4e3a\u53cc\u4fa7\u3002\u9762\u762b\u662f\u5bfc\u81f4\u534a\u6570\u60a3\u8005\u4f4f\u9662\u7684\u4e3b\u8981\u539f\u56e0\u3002MRI \u53ef\u4ee5\u663e\u793a\u8111\u795e\u7ecf\u5f25\u6f2b\u6027\u5f3a\u5316\uff0c\u5982\u56fe 3 \u6240\u793a\u3002<\/p>\n


<\/p>\n

\u5728\u4e34\u5e8a\u4e0a\uff0c\u5e94\u6ce8\u610f\u819d\u72b6\u795e\u7ecf\u8282\u3001\u9f13\u819c\u6216\u4e73\u7a81\u6bb5\u7684\u4e0d\u5bf9\u79f0\u6027\u6216\u660e\u663e\u5f3a\u5316\u4fe1\u53f7\uff0c\u800c\u8111\u6c60\u3001\u9762\u795e\u7ecf\u7ba1\u5185\u3001\u8ff7\u8def\u6216\u816e\u817a\u6bb5\u65e0\u589e\u5f3a\u3002\u5728\u9762\u762b\u7684\u68c0\u67e5\u4e2d MRI \u8fd8\u53ef\u6392\u9664\u538b\u8feb\u6027\u75c5\u53d8\u3001\u8111\u5e72\u6897\u6b7b\u3001\u795e\u7ecf\u5468\u56f4\u80bf\u7624\u6269\u6563\u6216\u795e\u7ecf\u9798\u7624\u7b49\u75c5\u53d8\u3002<\/p>\n


<\/p>\n

\u67d0\u4e9b MRI \u7684\u4f34\u968f\u8868\u73b0\u53ef\u4ee5\u63d0\u793a\u4e00\u4e9b\u708e\u75c7\u75c5\u56e0\uff0c\u5982 Guillain-Barr\u00e9\u7efc\u5408\u5f81\u3001\u591a\u53d1\u6027\u786c\u5316\u548c\u7ed3\u8282\u75c5\u3002\u5728\u5927\u591a\u6570\u9762\u762b\u75c5\u4f8b\u4e2d\u8111\u810a\u6db2\u5206\u6790\u662f\u4e00\u4e2a\u91cd\u8981\u7684\u8f85\u52a9\u68c0\u67e5\uff0c\u5c06\u6709\u52a9\u4e8e\u9274\u522b\u708e\u75c7\u548c\u611f\u67d3\u6027\u75be\u75c5\u3002<\/p>\n


<\/p>\n

\u75c5\u4f8b 3.<\/span><\/strong><\/span> 55 \u5c81\u5973\u60a3\u51fa\u73b0\u80cc\u90e8\u75bc\u75db\u8f90\u5c04\u5230\u80f8\u90e8\u3001\u624b\u81c2\u3001\u5934\u90e8\u548c\u9888\u90e8\uff0c\u5c24\u5176\u662f\u5728\u591c\u95f4\u8f83\u91cd\u30022 \u5468\u540e\u5979\u8fd8\u51fa\u73b0\u4e86\u53cc\u4fa7\u9762\u795e\u7ecf\u9ebb\u75f9\u3002\u8111\u810a\u6db2\u5206\u6790\u663e\u793a\uff0c594 \u4e2a\u7ec6\u80de\/mm3\uff08\u6b63\u5e38\u8303\u56f4 0-5\/mm3\uff09\u548c Bb \u7279\u5f02\u6027 IgG \u548c IgM \u6297\u4f53\u751f\u6210\u3002MRI T1 \u589e\u5f3a\u663e\u793a\u4e24\u4fa7\u9762\u795e\u7ecf\u5f3a\u5316\u3002\u6cbb\u7597 6 \u4e2a\u6708\u540e\u5f3a\u5316\u6d88\u5931\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 3. LNB \u7684\u9762\u795e\u7ecf\u708e\u3002T1 \u589e\u5f3a\uff08A\uff09\u663e\u793a\u4e24\u4fa7\u9762\u795e\u7ecf\u7684\u8fdc\u4fa7\u7ba1\u5185\u6bb5\u3001\u8ff7\u8def\u6bb5\u548c\u819d\u72b6\u795e\u7ecf\u8282\u6bb5\u660e\u663e\u5f3a\u5316\uff08\u7bad\u5934\uff09\u3002\u53f3\u4fa7 3 mm \u77e2\u72b6\u9762\u91cd\u5efa\u672f\uff08B\uff09\u663e\u793a\u7d2f\u53ca\u9f13\u5ba4\u548c\u4e73\u7a81\u6bb5\u53ca\u816e\u817a\u6bb5\u7684\u9762\u795e\u7ecf\u5f3a\u5316\uff0c\u5305\u62ec\u989e\u9762\u548c\u9888\u9762\u652f\uff08\u7bad\u5934\uff09\u3002\u6cbb\u7597 6 \u4e2a\u6708\u540e\u8f74\u5411 T1 \u589e\u5f3a\u663e\u793a\u9762\u795e\u7ecf\u5f3a\u5316\u6d88\u5931\uff08C\uff09\u3002<\/span><\/p>\n


<\/p>\n

 \u810a\u9ad3\u708e <\/span><\/strong><\/span><\/p>\n


<\/p>\n

LNB \u75c5\u810a\u9ad3\u708e\u7ea6\u5bfc\u81f4 7% \u7684\u60a3\u8005\u5165\u9662\u6cbb\u7597\u3002\u6240\u6709\u60a3\u8005\u5747\u7d2f\u53ca\u9888\u9ad3\uff0c\u5e76\u5e38\u5e38\u8868\u73b0\u4e3a\u810a\u9ad3\u4e2d\u5fc3\u6216\u8005\u7a0d\u524d\u65b9\u957f\u8282\u6bb5\u6027\u75c5\u53d8\uff0c\u5982\u56fe 4\u3002<\/p>\n


<\/p>\n

\u589e\u5f3a\u7076\u8303\u56f4\u4ece\u65e0\u5f3a\u5316\u5230\u7ed3\u8282\u72b6\u6216\u5f25\u6563\u6027\u5e7f\u6cdb\u6027\u5f3a\u5316\u3002\u5728\u6025\u6027\u6a2a\u8d2f\u6027\u810a\u9ad3\u708e\u76f8\u5173\u75c5\u53d8\u4e2d\uff0c\u795e\u7ecf\u6839\u6216\u8f6f\u810a\u819c\u5f3a\u5316\u7684\u5176\u5b83\u8868\u73b0\u6709\u52a9\u4e8e\u9274\u522b LNB \u4e0e MS \u53ca\u5176\u4ed6\u4e2d\u592e\u578b\u810a\u9ad3\u708e\u7684\u75c5\u56e0\uff0c\u5982\u6025\u6027\u64ad\u6563\u6027\u8111\u810a\u9ad3\u708e\u548c\u89c6\u795e\u7ecf\u810a\u9ad3\u708e\u8c31\u7cfb\u75c5\u3002<\/p>\n


<\/p>\n

\u8bb8\u591a\u611f\u67d3\u6027\u810a\u9ad3\u75c5\u53ef\u5408\u5e76\u51fa\u73b0\u8111\u819c\u708e\u3001\u795e\u7ecf\u6839\u708e\u548c\u8111\u708e\uff0c\u5982\u6c34\u75d8-\u5e26\u72b6\u75b1\u75b9\u75c5\u6bd2\u3001EB \u75c5\u6bd2\u3001\u8731\u4f20\u8111\u708e\uff08TBE\uff09\u548c\u5de8\u7ec6\u80de\u75c5\u6bd2\u3002\u75bc\u75db\u53f2\u4e5f\u662f LNB \u8bca\u65ad\u7684\u91cd\u8981\u7ebf\u7d22\uff0c\u4f46\u8111\u810a\u6db2\u5206\u6790\u662f\u6700\u5173\u952e\u7684\u8f85\u52a9\u68c0\u67e5\u3002<\/p>\n


<\/p>\n

\u75c5\u4f8b 4.<\/span><\/strong><\/span> 35 \u5c81\u5973\u6027\u8868\u73b0\u4e3a\u53f3\u81c2\u75bc\u75db\u3001\u9888\u90e8\u50f5\u786c\u3001\u5934\u75db\u3001\u75b2\u52b3\u3001\u6076\u5fc3\u3001\u5455\u5410\u7b49\u75c7\u72b6\u3002MRI T2 \u50cf\u8868\u73b0\u4e3a c2-c5 \u810a\u9ad3\u5185\u9ad8\u4fe1\u53f7\u3002\u8111\u810a\u6db2\u5206\u6790\u663e\u793a\u6dcb\u5df4\u7ec6\u80de\u6570\u589e\u52a0\uff0c\u4ee5\u53ca\u5728\u9798\u5185\u4ea7\u751f Bb \u7279\u5f02\u6027 IgM \u548c IgG \u6297\u4f53\u3002\u6cbb\u7597\u4e24\u4e2a\u6708\u540e\uff0c\u60a3\u8005\u5b8c\u5168\u5eb7\u590d\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 4. T2 \u50cf\u663e\u793a\u810a\u9ad3\u5185\u9ad8\u4fe1\u53f7\u3002\u77e2\u72b6\u4f4d\uff08A\uff09\u663e\u793a\u75c5\u53d8\u4f4d\u4e8e c2-c5 \u4e2d\u592e\uff08\u7bad\u5934\uff09\uff0cc2\/c3 \u5e73\u9762\u7684\u8f74\u4f4d\u56fe\u50cf\uff08B\uff09\u663e\u793a\u4e3b\u8981\u7d2f\u53ca\u53f3\u4fa7\u524d\u89d2\u9644\u8fd1\uff08\u7bad\u5934\uff09\u3002<\/span><\/p>\n


<\/p>\n

 \u5468\u56f4\u795e\u7ecf\u75c5 <\/span><\/strong><\/span><\/p>\n


<\/p>\n

Bannwarth \u7efc\u5408\u5f81\u4f34\u795e\u7ecf\u6839\u75bc\u75db\u548c\uff08\u6216\uff09\u9762\u762b\u662f\u5178\u578b\u7684 LNB \u8868\u73b0\u3002\u81c2\u4e1b\u795e\u7ecf\u708e\u6216\u5355\u7eaf\u6027\u591a\u53d1\u6027\u795e\u7ecf\u708e\u53ef\u89c1\u4e8e 5-10% \u7684 LNB \u60a3\u8005\uff0c\u4e34\u5e8a\u8868\u73b0\u4e3a\u6162\u6027\u4e0d\u5bf9\u79f0\u795e\u7ecf\u75c5\u53d8\uff0c\u901a\u5e38\u4e0d\u4f34\u6709\u8111\u819c\u708e\u6216\u9798\u5185\u6297\u4f53\u4ea7\u751f\u3002<\/p>\n


<\/p>\n

\u56fe 5 \u663e\u793a 1 \u4f8b LNB \u81c2\u4e1b\u795e\u7ecf\u708e\u6240\u81f4\u7684\u6025\u6027\u5468\u56f4\u795e\u7ecf\u635f\u5bb3\uff0c\u8be5\u60a3\u8005\u5728\u51fa\u73b0\u8fd0\u52a8\u635f\u4f24\u4e4b\u524d\u5e76\u6ca1\u6709\u810a\u795e\u7ecf\u6839\u708e\u7684\u75c7\u72b6\uff0c\u8fd9\u662f\u4e0d\u5178\u578b\u7684\u3002<\/p>\n


<\/p>\n

\u7531\u4e8e\u8fd9\u4e9b\u60a3\u8005\u75c7\u72b6\u7684\u5c40\u7076\u6216\u533a\u57df\u6027\u5206\u5e03\uff0c\u9664 MRI \u5916\u901a\u5e38\u8fd8\u9700\u8981\u8865\u5145\u4e34\u5e8a\u3001\u8840\u6db2\u548c\u7535\u751f\u7406\u68c0\u67e5\uff0c\u4ee5\u6392\u9664\u795e\u7ecf\u5361\u538b\u6216\u5360\u4f4d\u6027\u75c5\u53d8\u3002<\/p>\n


<\/p>\n

\u75c5\u4f8b 5. <\/span><\/strong><\/span>74 \u5c81\u5973\u6027\u53f3\u81c2\u8fdc\u7aef\u6025\u6027\u9ebb\u75f9\u60a3\u8005\u7684\u81c2\u4e1b\u795e\u7ecf\u708e\u3002\u5728\u75c5\u524d\u51e0\u5468\u60a3\u8005\u6709\u6076\u5fc3\u3001\u5455\u5410\u548c\u4f53\u91cd\u51cf\u8f7b\uff0c\u5e76\u4e14\u8d8a\u6765\u8d8a\u5065\u5fd8\u548c\u4e0d\u7a33\u5b9a\u3002<\/p>\n


<\/p>\n

STIR \u5e8f\u5217\u663e\u793a\u53f3\u4fa7\u795e\u7ecf\u675f\uff08\u7bad\u5934\uff09\u5f25\u6f2b\u6027\u4fe1\u53f7\u589e\u9ad8\u3002\u8170\u690e\u7a7f\u523a\u663e\u793a\u7ec6\u80de\u6570\u4e3a 101\/mm3\uff0c\u540c\u65f6\u8fd8\u663e\u793a\u51fa Bb IgG \u6297\u4f53\u6307\u6570\uff08AI\uff09\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 5. 74 \u5c81\u5973\u6027\u53f3\u81c2\u8fdc\u7aef\u6025\u6027\u9ebb\u75f9\u60a3\u8005\u7684\u81c2\u4e1b\u795e\u7ecf\u708e\u3002STIR \u5e8f\u5217\u663e\u793a\u53f3\u4fa7\u795e\u7ecf\u675f\uff08\u7bad\u5934\uff09\u5f25\u6f2b\u6027\u4fe1\u53f7\u589e\u9ad8\u3002<\/span><\/p>\n


<\/p>\n

 \u8111\u708e <\/span><\/strong><\/span><\/p>\n


<\/p>\n

\u8111\u5b9e\u8d28\u5f25\u6f2b\u6027\u975e\u7279\u5f02\u6027 MRI \u6539\u53d8\u4e34\u5e8a\u5c11\u89c1\u3002\u4f8b 6 \u4e2d\u7684\u75c5\u4f8b\u7c7b\u4f3c\u4e8e CLIPPERS\uff08\u5bf9\u7c7b\u56fa\u9187\u53cd\u5e94\u7684\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u6027\u708e\u75c7\u4f34\u8111\u6865\u5468\u56f4\u8840\u7ba1\u589e\u5f3a\u53cd\u5e94\uff09\uff0c\u7ecf\u4f7f\u7528\u6297\u751f\u7d20\u6cbb\u7597\u540e\u5f02\u5e38\u4fe1\u53f7\u7f13\u89e3\u3002<\/p>\n


<\/p>\n

\u4ece\u76ee\u524d\u5b58\u5728\u7684\u5c11\u6570\u75c5\u4f8b\u4e2d\u65e0\u6cd5\u786e\u5b9a LNB \u8111\u708e\u7684\u5177\u4f53\u53d7\u7d2f\u6a21\u5f0f\u3002\u4e0d\u8fc7\uff0c\u5b83\u4f3c\u4e4e\u66f4\u63a5\u8fd1\u4e8e\u5728\u83f1\u8111\u708e\u4e2d\u6240\u89c1\u7684\u7d2f\u53ca\u6a21\u5f0f\uff0c\u5982\u5355\u6838\u7ec6\u80de\u589e\u751f\u6027\u674e\u65af\u7279\u83cc\u3001\u7ed3\u6838\u7b49\u75be\u75c5\u4e2d\u7684\u8f6f\u8111\u819c\u5f3a\u5316\u5f62\u5f0f\u3002<\/p>\n


<\/p>\n

\u4e18\u8111\u53d7\u7d2f\u75c5\u4f8b\u5df2\u6709\u62a5\u9053\uff0c\u5176\u4ed6\u6025\u6027\u548c\u4e9a\u6025\u6027\u4e18\u8111\u75c5\u5305\u62ec\u65e5\u672c\u8111\u708e\u3001\u6025\u6027\u64ad\u6563\u6027\u8111\u810a\u9ad3\u708e\u3001\u767d\u585e\u6c0f\u75c5\u3001\u9759\u8109\u548c\u52a8\u8109\u6897\u585e\u3002\u4e18\u8111\u3001\u57fa\u5e95\u8282\u533a\u548c\u5c0f\u8111\u53d7\u7d2f\u4e5f\u63d0\u793a\u4e3a\u75c5\u6bd2\u6027\u8731\u5a92\u8111\u708e\u3002<\/p>\n


<\/p>\n

\u5728\u8731\u5a92\u611f\u67d3\u6d41\u884c\u5730\u533a\u5bf9\u7591\u4f3c\u8111\u708e\u60a3\u8005\u5e94\u5e38\u89c4\u8fdb\u884c Bb \u548c\u75c5\u6bd2\u6027\u8731\u5a92\u8111\u708e\u7279\u5f02\u6027\u6297\u4f53\u7684\u68c0\u6d4b\u3002<\/p>\n


<\/p>\n

\u75c5\u4f8b 6. <\/span><\/strong><\/span>45 \u5c81\u5973\u6027\u786e\u8bca\u4e3a LNB \u8111\u819c\u8111\u708e\uff0c\u4e34\u5e8a\u8868\u73b0\u4e3a\u75b2\u52b3\u3001\u5934\u75db\u3001\u5934\u6655\u3001\u5455\u5410\u3002\u67e5\u4f53\u8868\u73b0\u4e3a\u9707\u98a4\u548c\u6b65\u6001\u4e0d\u7a33\u3002\u8111\u810a\u6db2\u7ec6\u80de\u8ba1\u6570\u4e3a 270 \u4e2a\/mm3 \u53ca Bb \u6297\u4f53\u6307\u6570\u9633\u6027\u3002<\/p>\n

MRI \u8868\u73b0\u7c7b\u4f3c\u4e8e CLIPPERS\uff0c\u77e2\u72b6\u4f4d\uff08A\uff09\u548c\u6c34\u5e73\u4f4d\uff08B\uff09T1 \u589e\u5f3a\u53ef\u89c1\u8111\u51f8\u9762\u548c\u540e\u9885\u7a9d\u6591\u7247\u72b6\u8f6f\u8111\u819c\u5f3a\u5316\uff08\u7bad\u5934\uff09\uff0c\u8f74\u5411 T2 \u50cf\uff08C\uff09\u548c\u51a0\u72b6\u9762 FLAIR \u50cf\uff08D\uff09\u663e\u793a\u5de6\u4fa7\u4e18\u8111\uff08\u7bad\u5934\uff09\u9ad8\u4fe1\u53f7\u6539\u53d8\u3002<\/p>\n


<\/p>\n

DWI \u672a\u89c1\u5f25\u6563\u53d7\u9650\uff08\u672a\u5c55\u793a\uff09\u3002\u8f74\u5411\uff08E\uff09\u548c\u51a0\u72b6\u9762\uff08F\uff09T1 \u589e\u5f3a\u663e\u793a\u4e18\u8111\u8fb9\u7f18\u6709\u70b9\u72b6\u548c\u66f2\u7ebf\u5f3a\u5316\uff08\u7bad\u5934\uff09\u3002\u7c7b\u4f3c\u5730\u53f3\u4fa7\u4e18\u8111\u6539\u53d8\u3002<\/p>\n


<\/p>\n

2 \u4e2a\u6708\u540e\uff0c\u8f74\u5411 FLAIR \u56fe\u50cf\uff08G\uff09\u4ec5\u5728\u5de6\u4fa7\u4e18\u8111\uff08\u7bad\u5934\uff09\u51fa\u73b0\u7a0d\u9ad8\u4fe1\u53f7\uff0c\u800c T1 \u589e\u5f3a\u672a\u89c1\u5f3a\u5316\uff08H\uff09\uff0c\u6cbb\u7597\u4e00\u5e74\u540e\u65e0\u5f71\u50cf\u5b66\u5f02\u5e38\uff08I\uff09\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 6. 45 \u5c81\u5973\u6027 LNB \u8111\u819c\u8111\u708e\u3002<\/span><\/p>\n


<\/p>\n

\u75c5\u4f8b 7. <\/span><\/strong><\/span>40 \u5c81\u5973\u6027\u786e\u8bca\u4e3a LNB \u8111\u708e\uff0c\u5934\u75db\u3001\u5455\u5410\u3001\u5934\u6655\u53ca\u4eba\u683c\u6539\u53d8\u75c5\u53f2 1 \u5929\u3002\u8111\u810a\u6db2\u7ec6\u80de\u8ba1\u6570\u4e3a 182 \u4e2a\/mm3\u3002<\/p>\n


<\/p>\n

MRI T2\uff08a\uff09\u53ca FLAIR\uff08b\uff0cc\uff09\u663e\u793a\u4e0b\u4e18\u8111\uff08a\uff09\u3001\u8111\u811a\u3001\u4e2d\u8111\u3001\u8111\u6865\uff08b\uff09\u53ca\u5c0f\u8111\u9f7f\u72b6\u6838\uff08c \u5185\u7bad\u5934\uff09\u5bf9\u79f0\u6027\u5f25\u6f2b\u6027\u6591\u7247\u72b6\u9ad8\u4fe1\u53f7\uff0c\u6269\u6563\u52a0\u6743\u6216\u9020\u5f71\u5242\u540e\u5747\u65e0\u5f02\u5e38\uff08\u56fe\u7247\u672a\u663e\u793a\uff09\u3002\u8fdb\u4e00\u6b65\u7684\u4e34\u5e8a\u548c\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u663e\u793a\u53f3\u817f\u6709\u79fb\u884c\u6027\u7ea2\u6591\u548c\u8111\u810a\u6db2 Bb IgG \u6297\u4f53\u9633\u6027\u3002TBE \u6297\u4f53\u68c0\u6d4b\u9634\u6027\u3002<\/p>\n


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\u5979\u63a5\u53d7\u4e86\u6297\u83cc\u6cbb\u7597\uff0c8 \u5468\u540e MRI \u68c0\u67e5\u663e\u793a\u5f02\u5e38\u4fe1\u53f7\u6d88\u5931\uff08d-f\uff09\u3002<\/p>\n


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\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 7.<\/span><\/p>\n


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 \u8111\u8840\u7ba1\u708e <\/span><\/strong><\/span><\/p>\n


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LNB \u8840\u7ba1\u708e\u88ab\u8ba4\u4e3a\u662f\u7531\u4e8e\u87ba\u65cb\u4f53\u611f\u67d3\u7684\u708e\u75c7\u53cd\u5e94\u5f15\u8d77\u7684\u3002\u83b1\u59c6\u75c5\u53d1\u751f\u8111\u8840\u7ba1\u708e\u7684\u51e0\u7387\u4e3a 0.3%\uff0c\u5728 LNB \u8840\u7ba1\u708e\u4e2d\u5e38\u7d2f\u53ca\u540e\u5faa\u73af\u3002\u8bc6\u522b\u8fd9\u79cd\u5e76\u53d1\u75c7\u5f71\u50cf\u5b66\u662f\u5fc5\u987b\u7684\uff08\u5982\u56fe 8\uff09\u3002<\/p>\n


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\u5bf9\u4e8e\u653e\u5c04\u79d1\u533b\u751f\u548c\u4e34\u5e8a\u533b\u751f\u6765\u8bf4\uff0c\u91cd\u8981\u7684\u662f\u8981\u610f\u8bc6\u5230 LNB \u53ef\u80fd\u662f\u5f15\u8d77\u5352\u4e2d\u548c\u8840\u7ba1\u708e\u7684\u539f\u56e0\u4e4b\u4e00\u3002<\/p>\n


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\u75c5\u4f8b 8.<\/span><\/strong><\/span> 55 \u5c81\u83b1\u59c6\u75c5\u8840\u7ba1\u708e\u60a3\u8005\uff0c\u5165\u9662\u524d 3 \u5929\u51fa\u73b0\u884c\u4e3a\u5f02\u5e38\uff0c\u8868\u73b0\u4e3a\u8bed\u65e0\u4f26\u6b21\uff0c\u8ff7\u5931\u65b9\u5411\u3002\u8111\u810a\u6db2\u7ec6\u80de\u8ba1\u6570\u4e3a 213 \u4e2a\/mm3\uff0cBb IgG \u9633\u6027\u3002\u53cc\u4fa7\u4e18\u8111\uff08a-f\uff09\u3001\u53f3\u4fa7\u5927\u8111\u811a\uff08g-i\uff09\u548c\u53f3\u4fa7\u6795\u53f6\u76ae\u8d28\uff08\u672a\u5c55\u793a\uff09\u663e\u793a\u5904\u4e8e\u4e0d\u540c\u65f6\u671f\u7684\u7f3a\u8840\u6027\u75c5\u53d8\u3002<\/p>\n


<\/p>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"
\u56fe 8.<\/span><\/p>\n

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\u9605\u8bfb\u63a8\u8350\uff1a<\/span><\/strong><\/span><\/p>\n


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\u8d85\u8fc7 4.5 \u5c0f\u65f6\uff0c\u8fd8\u6eb6\u6813\u5417\uff1f<\/a>
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\u7f16\u8f91 | \u738b\u5f18<\/span><\/p>\n

\u6295\u7a3f\u53ca\u5408\u4f5c | wanghong@dxy.cn
\u9898\u56fe\u6765\u6e90 | \u7ad9\u9177\u6d77\u6d1b<\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\"\u795e\u7ecf\u7cfb\u7edf\u83b1\u59c6\u75c5\u7684\u5f71\u50cf\u5b66\u7279\u70b9\"<\/p>\n

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\u53c2\u8003\u8d44\u6599\uff1a<\/p>\n


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1.Lindland E S, Solheim A M, Andreassen S, et al. Imaging in Lyme neuroborreliosis[J]. Insights Into Imaging, 2018\uff086\uff09:1-12.<\/p>\n


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2.Aman Dabir, Gauri Pawar.Teaching NeuroImages: Lyme disease presenting as Bannwarth syndrome[J].Neurology Oct 2018, 91 \uff0815\uff09: e1459-e1460.<\/p>\n


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3.Isabelle Beuchat, Vincent Dunet, Pascal Meylan, et al.Late Lyme neuroborreliosis with chronic encephalomyelitis[J]. Neurology Sep 2018, 91 \uff0813\uff09 627-628.<\/p>\n


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<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section><\/div>\n","protected":false},"excerpt":{"rendered":"

\u83b1\u59c6\u75c5\u662f\u4e00\u79cd\u4ee5\u8731\u4e3a\u5a92\u4ecb\u7684\u87ba\u65cb\u4f53\u611f\u67d3\u6027\u75be\u75c5\uff0c\u662f\u7531\u4f2f\u6c0f\u758f\u87ba\u65cb\u4f53\uff08Borrelia Burgdorferi\uff0cBb\uff09\u6240 […]<\/p>\n","protected":false},"author":1,"featured_media":63299,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[2],"tags":[],"_links":{"self":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/63298"}],"collection":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/comments?post=63298"}],"version-history":[{"count":1,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/63298\/revisions"}],"predecessor-version":[{"id":63310,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/posts\/63298\/revisions\/63310"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media\/63299"}],"wp:attachment":[{"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/media?parent=63298"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/categories?post=63298"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.05921.net\/index.php\/wp-json\/wp\/v2\/tags?post=63298"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}