摘要
目的掌握2008年云南省克山病病情，为克山病防治提供科学依据。方法在云南省克山病病区抽取6个县（市）的18个自然村作为调查点，调查对象为调查点的居民。收集各调查点户籍人口与常住人口资料，对调查对象进行以心血管系统疾病为主的临床检查，并描记心电图；可疑克山病者拍摄2m后前位胸部正位X线片，按《克山病诊断标准》（GB17021—1997）确诊克山病病例。每个调查点采集10份主食粮食样品及10份男性儿童枕后头发样品进行含硒量测定。结果2008年全省6个县（市）18个调查点共调查9818人，共检出潜在型和慢型克山病34例，总检出率为0．35％（34／9818）．其中检出潜在型克山病32例，检出率为0．33％（32／9818），检出慢型克山病2例，检出率为0．02％（2／9818）；急型和亚急型克山病未检出。在检出的34例克山病现患病例中，5—14岁占67．65％（23／34）。18个调查点中．共描记心电图9818份，心电图有异常改变的有677份，异常率为6．90％（677／9818）；共拍摄X线胸片56例，心胸比例≤0．50者占83．93％（47／56），0．51。0．55者占8．93％（5／56），0．56—0．60者占7．14％（4／56）。18个调查点采集大米、头发样品各180份，大米样品含硒量最低的为永胜县[（0．006±0．001）mg／kg]，最高的为通海县[（0．027±0．009）mg／kg]，平均为（0．013±0.010）mg／kg；发硒最低的为永胜县[（0．145±0．043）mg／kg]，最高的为通海县[（0．297±0．062）mg／kg]，平均为（0．252±0．078）mg／kg。结论云南省克山病检出率较低，但检出病例集中在5，14岁年龄段，说明克山病致病因子仍然活跃。调查点外环境粮食及居民发硒水平处于较低水平以及各地差异比较大，有必要在克山病重病区开展补硒预防克山病工作。
Objective In order to master the current situation of Keshan disease in Yunnan province and to provide scientific basis for Keshan disease control and prevention. Methods Eighteen villages were selected as the investigation sites in 6 counties across all the Keshan disease wards in Yunnan province, where the residents were investigated. Then, the villages census data was collected, clinical examination aiming mainly on cardiovascular system was carried out, including electrocardiography and X-ray to the suspected patients. Correct diagnose of Keshan disease was made by the Diagnostic Standard of Keshan Disease （GB 17021-1997）. At the same time, 10 food samples and 10 hair samples for detecting selenium content in every investigation site. Results There were 9818 residents investigated in the 18 investigation sites in 6 counties, and 34 cases of Keshan disease were found, the total incidence rate was 0.35%（34/9818）. Among the 34 Keshan disease cases, 32 cases were latent Keshan disease, the incidence rate was 0.33% （32/9818）; 2 cases were chronic Keshan disease, the incidence rate was 0.02%（2/9818）. There was no any acute and sub acute cases be found. Most Keshan disease cases aged from 5 to 14, 67.65% （23/34）. Abnormal ECG rate was 6.90% （677/9818）. Among 56 X-ray films, 47 cases had a cardiothoraeic ratio less than or equal to 0.50,83.93%（47/56）, 5 cases from 0.51 to 0.55, 8.93%（5/56）, 4 cases from 0.56 to 0.60, 7.14%（4/56）. Selenium content was detected in 180 food samples and 180 hair samples. The average food selenium content（mg/kg） was 0.013 ± 0.010, the lowest content in Yongsheng county（0.006 ± 0.001）, the highest content in Tonghai county（0.027 ± 0.009）. The average hair selenium contentwas（0.252 ± 0.078）mg/kg, with the lowest（0.145 ± 0.043）mg/kg in Yongsheng county, the highest （0.297 ± 0.062）mg/kg inTonghai county. Conclusions The detected ratio of Keshan disease is low in Yunnan province. Most of Keshan disease patients age from 5 to 14. It was presented that the Keshan disease infectious agents were still strong and active. The foodstuffs and hair Selenium content is low in food and hair sample, and varies in different investigation site. It is necessary to supply selenium for prevent Keshan disease in the severe areas.
出处
《中国地方病学杂志》
CAS
CSCD
北大核心
2010年第1期93-95,共3页
Chinese Jouranl of Endemiology
基金
基金项目：中央补助地方公共卫生专项资金地方病防治项目（2007）
关键词
克山病
数据收集
心电描记术
X线
硒
Keshan disease
Data collection
Electrocardiography
X-rays
Selenium
