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摘要: 新埃立克体病是一种新发的蜱传自然疫源性疾病。 2010年瑞典首次报道该病，目前欧洲和亚洲多个国家均有流行。 本研究对新埃立克体病的病原学、流行病学、临床表现及诊断治疗的相关研究进展进行综述，旨在提高临床和疾控人员对新埃立克体病的认知，增强诊治和防控能力，并为今后深入研究奠定基础。Abstract: Neoehrlichiosis is a new tick-borne natural focal disease. The disease was first reported in Sweden in 2010 and is now endemic in several countries in Europe and Asia. This article reviews the etiology, epidemiology, clinical manifestations, diagnosis and treatment of neoehrlichiosis for improving the knowledge of clinical and disease control worker on neoehrlichiosis, enhancing the ability of diagnosis, treatment and control, and building the foundation of further research.
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Key words:
- Neoehrlichiosis /
- Neoehrlichia mikurensis /
- Epidemiology /
- Clinical manifestation /
- Clinical diagnosis /
- Treatment
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表 1 新埃立克体病患者基本情况
Table 1. Basic information of patients with Neoehrlichiosis
国家 确诊时间
（年）年龄
（岁）性别 基础病史 接受过的药物治疗 脾切
除术参考
文献德国 2007 69 男 慢性炎症性脱髓鞘性多发性神经病 环磷酰胺、皮质类固醇、利妥昔单抗 无 ［3］ 2008 57 男 无 无 无 捷克 2008 55 女 套细胞淋巴瘤 利妥昔单抗、阿糖胞苷、米托蒽醌、甲氨蝶呤 有 ［4］ 2009 58 男 原发性硬化性胆管炎、B细胞淋巴瘤 利妥昔单抗 有 瑞士 2009 61 男 主动脉瓣关闭不全、三尖瓣关闭不全 无 无 ［5］ 2011 68 男 慢性淋巴细胞白血病 无 有 ［6］ 2012 58 男 淋巴瘤 利妥昔单抗、 环磷酰胺、 多柔比星、 长春新碱、 强的松 无 瑞典 2009 77 男 慢性B细胞淋巴细胞白血病 皮质类固醇、环磷酰胺 有 ［7］ 2011 75 女 慢性淋巴细胞白血病 硫唑嘌呤、皮质类固醇 有 ［8］ 2011 67 男 滤泡性淋巴瘤、系统性红斑狼疮 皮质类固醇 有 2013 67 女 颗粒淋巴细胞白血病、银屑病关节炎 环磷酰胺、皮质类固醇 有 2013 54 男 银屑病 环磷酰胺、皮质类固醇 无 2013 59 男 弥漫大 B 细胞淋巴瘤、类风湿关节炎 环磷酰胺 有 2014 78 男 类风湿关节炎 甲氨蝶呤、利妥昔单抗 无 ［9］ 2014 55 男 肉芽肿性多血管炎 利妥昔单抗 无 2014 57 男 急性B淋巴细胞型白血病 硫唑嘌呤、甲氨蝶呤、皮质类固醇 无 2015 71 女 类风湿关节炎 甲氨蝶呤 无 ［10］ 2017 57 女 多发性硬化症 利妥昔单抗 无 ［11］ 2019 48 女 多发性硬化症 利妥昔单抗 无 ［12］ 瑞典 2019 54 男 肉芽肿性多血管炎 利妥昔单抗、白介素-1受体拮抗剂、皮质类固醇 无 ［12］ 2019 62 男 多发性硬化症 利妥昔单抗 无 不详 58 男 滤泡性淋巴瘤 利妥昔单抗 无 ［13］ 不详 63 女 低丙种球蛋白血症 无 有 不详 65 女 自身免疫性溶血性贫血 免疫抑制剂 有 中国 2010 35 男 无 无 无 ［14, 17］ 2010 67 女 无 无 无 2010 50 男 无 无 无 2010 29 男 无 无 无 2010 37 男 无 无 无 2010 58 男 无 无 无 2010 41 女 无 无 无 斯洛文尼亚 2019 66 女 弥漫大B细胞淋巴瘤 利妥昔单抗、 环磷酰胺、 多柔比星、 长春新碱、 强的松 有 ［15］ 法国 2021 54 男 无 无 无 ［16］ 2021 67 女 慢性淋巴细胞白血病 依鲁替尼 有 2021 61 男 无 无 无 2021 66 男 滤泡性淋巴瘤 无 无 
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表 2 不同国家和人群的新埃立克体病感染情况
Table 2. Neoehrlichiosis infection in different countries and populations
报告年份 国家 调查人群 检测方法 核酸阳性率（%） 核酸阳性病例数/疑似病例数 参考文献 2012 中国 蜱叮咬发热患者 巢式PCR 1.13 7/622 ［17］ 2014 波兰 林业工作者 巢式 PCR 1.58 5/316 ［18］ 2015 瑞典 蜱叮咬患者 荧光定量PCR 1.96 2/102 ［19］ 2016 荷兰 蜱叮咬及游走性红斑患者 荧光定量PCR 1.12 7/626 ［20］ 2017 挪威 蜱叮咬患者 荧光定量PCR 10.00 7/70 ［21］ 2018 瑞典 疑似无形体病患者 荧光定量PCR 1.98 2/101 ［13］ 2021 法国 疑似无形体病患者 荧光定量 PCR 0.43 4/934 ［16］ 2021 奥地利 蜱叮咬患者 荧光定量 PCR 2.21 11/498 ［22］ 注：PCR. 聚合酶链式反应
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