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目的探讨新疆部分自然疫源地自然人群感染莱姆病螺旋体的自然进程及感染莱姆病螺旋体的基因型情况。方法在2002年夏季完成的1406人莱姆病螺旋体感染血清流行病学调查的基础上,2006年在上述1406人中的1390人阴性人群中,随机抽取119人,与2002年16例阳性(共计135人)为研究对象,在这两个时点收集的血清标本均应用蛋白印迹(Western blot,WB)方法检测抗Borrelia burgdorferi抗体IgM和IgG,并完成莱姆病表现频率调查问卷。同时留取135份尿液标本,应用巢式PCR扩增尿液标本中莱姆病螺旋体5S～23SrRNA间隔区片段,对部分阳性产物测序分析,确定莱姆病螺旋体的基因型,并将PCR检测结果与血清学的检测结果相比较。结果 2002年1406份血清标本中,抗体阳性16份,阴性1390份,阳性率为1.14%(16/1406)(16例中IgM阳性12例,IgG阳性2例,IgM、IgG均阳性者2例)。2006年上述16例抗体阳性的感染者中,有7例抗体转为阴性,阴转率为43.75%(7/16),4例由IgM阳性转为IgG阳性,IgM持续阳性5例,2002年抗体阴性的119人中,2006年有58例抗体转为阳性(IgM阳性14例,IgG阳性25例,IgM和IgG均阳性的19例),阳转率为48.74%(58/119),确诊为莱姆病2例。2006年抗B.burgdorferi抗体总阳性率为49.63%(67/135)(2006年阳性58例+2002年阳性9例)。无症状IgG血清转换率为34.07%(46/135)(2002年IgM阳性转换为IgG阳性的4例+2006年IgG阳性的25例、IgM和IgG均阳性的19例,其中确诊莱姆病2例);3例发展为莱姆病(2.22%)。135份尿液PCR检测,阳性22份,阳性率为16.30%(22/135)。8份PCR阳性结果测序分析显示7份为B.garinii,1份为B.afzelii基因型。结论新疆自然疫源地人群莱姆病螺旋体感染大多为隐性感染,自然进程较为良性,临床莱姆病少有发生。新疆人群莱姆病螺旋体感染基因型主要为B.garinii,其次是B.afzelii。
Objective To explore the natural process of infection of Borrelia burgdorferi and the genotype of Borrelia burgdorferi infected by natural population in some natural foci of Xinjiang. Methods Based on a serological epidemiological survey of 1406 cases of Lyme disease in China in the summer of 2002, we randomly selected 119 of the 1406 negative subjects from 1390 in 2006, compared with 16 cases in 2002 (total 135). The serum samples collected at these two time points were all tested for anti-Borrelia burgdorferi IgM and IgG by Western blot (WB), and the frequency of Lyme disease was investigated. At the same time, 135 samples of urine were collected. Nested PCR was used to amplify the 5S ~ 23SrRNA spacer region of Borrelia burgdorferi in urine samples. The partial positive products were sequenced to determine the genotype of Borrelia burgdorferi and PCR detection Results compared with serological test results. Results Of the 1406 serum samples collected in 2002, 16 were positive and 1390 were negative, the positive rate was 1.14% (16/1406). Among the 16 cases, 12 were IgM positive, 2 were IgG positive, 2 were IgM and IgG positive ). Of the 16 antibody-positive patients in 2006, 7 were negative, with a negative conversion rate of 43.75% (7/16), 4 were IgM positive and IgG positive, 5 were IgM persistent in 2002 Of the 119 antibody-negative individuals, 58 were positive for antibodies in 2006 (IgM positive in 14, IgG positive in 25, IgM and IgG positive in 19), and the positive rate was 48.74% (58/119) Lyme disease in 2 cases. The total positive rate of anti-B. burgdorferi antibody in 2006 was 49.63% (67/135) (58 positive in 2006 + 9 positive in 2002). Serum conversion rate of asymptomatic IgG was 34.07% (46 of 135) (in 2002 IgM positive conversion to IgG-positive in 4 cases + 2006 IgG-positive 25 cases, IgM and IgG were positive in 19 cases, of which confirmed Lyme disease 2 Cases); 3 cases developed Lyme disease (2.22%). Totally 135 urine samples were detected by PCR. The positive rate was 16.30% (22/135). Sequencing analysis of 8 PCR positive results showed that 7 were B. garinii and 1 was B. afzelii genotype. Conclusion Most people infected with Lyme disease in natural foci of Xinjiang are latent infection, and their natural course is benign. There are seldom clinical lyme disease. The genotypes of Borrelia burgdorferi in Xinjiang were B.garinii, followed by B.afzelii.