莱姆病的概况及其防治研究进展

Overview of Lyme Disease and Research Progress on Its Prevention and Control

摘要: 本文系统阐述了莱姆病的致病机制、流行病学特征、临床表现、诊断技术及防控策略。该疾病属于新发人畜共患病范畴，其致病源为伯氏疏螺旋体为病原体，可通过蜱媒途径实现病原传播。其临床表现有三个阶段，早期以游走性红斑为主，中期主要累及神经和心血管系统，晚期则表现为慢性关节炎和神经系统损伤。在全球范围内，莱姆病分布比较广泛，分布在五大洲的70余个国家，我国现统计已有30个省份报告病例，主要聚集在东北、西北一带以及内蒙古草原地区。该病诊断主要依托蜱虫叮咬史、典型的临床症状为主要依据，并辅以病原学特征及血清学检测，从而确诊该病病例。治疗以抗生素为主，如多西环素、阿莫西林和头孢曲松，根据其病情的发展阶段和损害器官程度不同选择不同方案。预防层面，疫苗目前尚未全球普及，日常防控措施至关重要。未来需持续研发高精尖诊断技术，提升莱姆病防控水平，保障公共卫生安全。

Abstract: This paper provides a detailed overview of the etiological characteristics, epidemiological distri- bution, clinical manifestations, laboratory examinations, and prevention and control measures of tick-borne Lyme disease. Caused by Borrelia burgdorferi and transmitted through tick bites, Lyme disease is an emerging zoonosis. Clinically, it manifests in stages, with early-stage erythema migrans being predominant, followed by potential involvement of the nervous and cardiovascular systems in the intermediate stage, and chronic arthritis and neurological damage in the late stage. Globally, Lyme disease is distributed across more than 70 countries in five continents, with cases reported in 30 provinces in China, primarily concentrated in forested regions of Northeast, Northwest, and Inner Mongolia. Diagnosis relies on a history of tick bites, typical clinical presentations, and etiological and serological tests. Antibiotic therapy, including doxycycline, amoxicillin, and ceftriaxone, is the mainstay of treatment, with regimens tailored to the disease stage and affected organs. Vaccines are not yet globally available, emphasizing the importance of tick prevention measures. Future efforts should focus on developing highly sensitive diagnostic technologies to enhance Lyme disease prevention and control and safeguard public health.