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目的：分析１４例莱姆病被误诊的原因。方法：免疫荧光试验、酶联免疫吸附试验、蛋白电泳足迹测定。结果：被误诊的１４例患者均以神经系统症状为首发，提示无发热、皮疹的最初表现，而反复出现神经系统损伤或潜伏期长，有明显的格林巴利综合症和面瘫病史，按神经系统疾病治疗或激素治疗无效，夜间蚁走样感觉明显，肌电图示神经原性损伤，脑脊液蛋白偏高，其余各项检查正常，应做莱姆病检查。合并格林巴利综合症的莱姆病患者，除用大剂量抗菌素外，还应以少量激素冲击治疗。结论：没有明显“三期”的莱姆病患者，症状与其他疾病很接近，易被误诊。
Objective: To analyze the causes of misdiagnosis of 14 cases of Lyme disease. Methods: Immunofluorescence assay, enzyme - linked immunosorbent assay, protein electrophoresis footprinting. Results: All the 14 patients who were misdiagnosed started with neurological symptoms, suggesting no initial symptoms of fever and skin rash. However, there were repeated nervous system injuries or long latent periods, with obvious history of Guillain-Barre syndrome and facial paralysis. According to the nervous system Disease treatment or hormone therapy is invalid, night ants feel obvious, EMG neurogenic injury, cerebrospinal fluid protein is high, the rest of the checks were normal, Lyme disease should be checked. Lyme disease combined with Guillain-Barre syndrome, in addition to using large doses of antibiotics, but also with a small amount of hormone shock treatment. Conclusion: There is no obvious “three” Lyme disease patients, the symptoms and other diseases are very close, easily misdiagnosed.