患者女性,40岁,本地林业工人,主诉数年前曾有蜱叮咬史,上肢、腰背部出现片状红斑,伴有发热、头疼等,双膝及肩、臂等多处关节反复疼痛,呈游走性,有心悸和思维减退现象,下肢端皮肤损害。 1992年6月18日体检:外观四肢浮肿,心肺未见异常、肝睥无肿大、双膝关节不对称,左膝明显肿大,双脚面呈典型的慢性萎缩性肢皮炎(ACA)病变。化验: A female patient, aged 40, a native forestry worker, complained of history of tick bites a few years ago. Flaky erythema was found in the upper extremities and lower back accompanied by fever and headache. Her knees, shoulders and arms repeatedly acted repeatedly. Migratory, palpitations and reduced thinking, lower extremity skin damage. June 18, 1992 physical examination: the appearance of edema limbs, no abnormal heart and lungs, liver enlargement, asymmetric knees, left knee was significantly enlarged, feet were typical of chronic atrophic limb acinar (ACA) lesions. assay: