黑龙江省克山病病区内外环境硒水平及人群柯萨奇B组病毒感染现况调查  

A current survey on the selenium status and coxsakievirus B infection in Keshan disease area, Heilongjiang Province

作　　者：裴俊瑞[1] 王宇[1] 李兴洲[1] 高琳[1] 闫丽佳[1] 李奇[1] 侯杰[1] 周令望[1] 张立君[1] 陈洁[1] 张辉[1] 王铜[1] 

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心克山病防治研究所.卫生部病因流行病学重点实验室(23618504),150081

出　　处：《中国地方病学杂志》2008年第5期532-534,共3页Chinese Jouranl of Endemiology

基　　金：黑龙江省自然科学基金重点项目（ZJY04-07）;中国疾病预防控制中心及卫生部委托项目（2007）;黑龙江省卫生厅课题（2005-005）;哈尔滨医科大学创新群体基金（2006）

摘　　要：目的了解黑龙江省克山病病区内外环境硒水平及柯萨奇B组病毒（CVB）人群感染情况，为采取有针对性的防治措施提供依据。方法在克山病病区设立病区病例组和病区对照组，在非病区设立非病区对照组，采集血液样品用于检测血硒及CVB IgM抗体，同时采集病区和非病区土壤、粮食用于硒测定：硒的测定采用氢化物发生原子荧光光度法，CVB IgM抗体采用酶联免疫吸附法（ELISA）检测。结果病区土壤、玉米、小麦、大豆含硒量[（0．092±0．011）、（0．003±0．001）、（0．005±0．003）、（0．006±0．001）mg／kg]均低于非病区[（0．198±0．016）、（0．012±0．004）、（0．037±0．007）、（0．037±0．008）mg／kg]，二者比较差异均有统计学意义（t值分别为17．007、8．551、15．842、12．109，P〈0．01）。病区病例组血硒[（34．803±13．302）μg／L]低于病区对照组[（41．235±13．571）μg／L]，二者比较差异有统计学意义（P〈0．05）；病区病例组、病区对照组、非病区对照组的CVB感染阳性率分别为90．0％（36／40）、68．3％（41／46）、45．8％（22／48），病区和非病区CVB感染的比值比（OR）为3．957，95％可信区间为1．898～8．246；病区病例组和病区对照组CVB感染的OR值为4．171．95％可信区间为1．298～13．404；CVB感染组与未感染组血硒水平比较，差异无统计学意义（t=1．179，P〉0．05）。结论黑龙江省克山病病区仍存在低硒及CVB感染情况。Objective To acquaint the situation of selenium nutrition level and coxsakievirus B （CVB） infection in Keshan disease（KD） patients in Heilongjiang province, and provide the evidence for taking the direction measurements of KD control. Methods The subjects were divided into three groups： disease area KD group, disease area control group, and non-disease area control group. We collected soil, food and blood, which were used to detect selenium content, and assay IgM antibody of CVB in plasma. The selenium content of blood was determined with hydride generation atomic fluorometry spectrometric. The IgM antibody of CVB was measured with ELISA test Kit. Results Compared with those in non-disease areas, selenium content of soil, maize, wheat and bean（0.092 ± 0.011,0.003 ± 0.001,0.005 ± 0.003,0.006 ±0.001 ）μg/L in disease area were significantly lower（t = 17.007, 8.551, 15.842,12.109; all P 〈 0.01）. In disease area, the levels of blood selenium in disease area KD group（34.803 ±13.302）μg/L was obviously decreased compared to disease area control group（41.235 ± 13.571） μg/L （P 〈 0.05）. The rate of CVB infection among disease area KD group, control in disease area and control in non-disease area were 90.0%, 68.3% and 45.8%. The odds ratio （OR） value of CVB infected exposure between disease area and non-disease area was 3.957, and the 95% confidence interval（CI） was 1.898 - 8.246. The OR value of CVB infected exposure between KD group and control group was 4.171, with the 95% CI of 1.298 - 13.404. Compared with CVB non-infection group, blood selenium of CVB infection group was lower, but not significantly（t = 1.179, P 〉 0.05）. Conclusions Selenium defciency and CVB infection still exist in KD area, Heilongjiang Province.

关 键 词：克山病 硒 肠道病毒B型 人 

分 类 号：R686[医药卫生—骨科学]