1990—2007年河北省克山病病情监测结果分析  

Analysis in the result of Keshan disease surveillance in Hebei province from 1990 to 2007

作　　者：马东瑞[1] 马景[1] 贾丽辉[1] 杜永贵[1] 姚光俊[1] 周朝辉[1] 吕胜敏[1] 

机构地区：[1]河北省疾病预防控制中心地方病防治所,石家庄050021

出　　处：《中国地方病学杂志》2010年第2期203-207,共5页Chinese Jouranl of Endemiology

基　　金：卫生部疾病控制司委托项目（1990-2007）

摘　　要：目的观察1990—2007年河北省克山病病情动态变化，为制订防治措施提供科学依据。方法采用回顾性方法．对河北省疾病预防控制中心地方病防治所1990—2007年按照《全国克山病病情监测方案》和《克山病监测》（W／T78—1996）所进行的克山病病情监测资料，对克山病临床体检结果、心电图检查情况、克山病病人及疑似病人胸部x线检查资料，以及1990、1992和1999年的发硒检测结果进行分析。结果1990—2007年监测点无急型、亚急型克山病病人发生，共新发潜在型克山病病人35例，新发自然慢型克山病病人1例，慢型克山病检出率范围为1．12％（8／713）～8．18％（27／330），潜在型克山病检出率范围为2．29％（19／831）～8．20％（45／549）．3～14岁儿童和20～45岁育龄妇女克山病检出率逐年下降，45岁以上人群成为当前克山病患病主体。克山病患者主要心电图异常改变为完全性右束支传导阻滞、ST—T改变、频发性室性早搏和左前分支传导阻滞，克山病患者心脏增大检出率平均为47．00％（211／449），2005年后心脏中度以上增大检出率显著增加[28．57％（8／28）～48．39％（15／31）]。1990—2007年慢型克山病死亡率平均为18．00％（18／100）。结论河北省克山病病情呈缓慢下降趋势，病情处于相对稳定状态。河北省仍是全国克山病病情较重的地区，克山病防治任务还很艰巨．加强克山病病情监测和开展克山病的管理与治疗是防治工作的重点。Objective To observe the dynamic changes of prevalence of Keshan disease（KD） in Hebei province from 1990 to 2007, to provide scientific basis for its prevention and treatment. Methods The surveillance data of KD was analyzed according to ＂the National Scheme of KD Surveillance and the Surveillance of KD＂ （W/T 78-1996） in Hebei province from 1990 to 2007 by the Institute for Prevention of Endemic Disease in Hebei Province Center for Disease Control and Prevention. The data included physical examination, electrocardiogram （ECG）, the chest X-ray film of KD patients and the suspected patients, as well as selenium contents of hair collected in 1990, 1992 and 1999. Results No new cases of acute and subacute types of KD patients were found at the surveillance sites from 1990 to 2007. Thirty-five cases of new latent KD and one case of spontaneous chronic KD were identified respectively. Prevalence of chronic and latent KD ranged from 1.12% （8/713） to 8.18% （27/330） and 2.29% （19/831） to 8.20% （45/549） in Hebei province from 1990 to 2007, respectively. The prevalence of KD in children aged 3 - 14 years old and childbearing woman aged 20 - 45 years old decreased year by year, however population over 45 years old were more likely suffering from KD. The major abnormal changes of ECG in KD patients were complete right bundle branch block, ST-T change frequent premature ventricular contraction, and left anterior fascicular block. The prevalence of the heart enlargement in KD patients was 47.00% （211/449） averagely, and the prevalence of heart enlargement of medium grade increased remarkably after 2005 [28.57%（8/28） - 48.39%（15/31）]. The average mortality in chronic KD patients was 18.0%（18/100） from 1990 to 2007. Conclusions The prevalence of KD decreased slowly in Hebei province. Hebei province is still the region with higher prevalence of KD around the country, and the tasks of prevention and treatment of KD is still urgent. Enhancing the surveillance of of KD and carrying out

关 键 词：克山病 心电图 X线 监测 硒 

分 类 号：R686[医药卫生—骨科学]