2007—2011年陕西省宝鸡市克山病监测结果分析  

Analysis of monitoring results of Keshan disease from 2007 to 2011 in Baoji City of Shaanxi Province

作　　者：高艳芹[1] 朱宏伟[1] 邓峰[1] 车维锋[1] 高健[1] 刘梅[1] 

机构地区：[1]陕西省宝鸡市疾病预防控制中心地方病防治科,721006

出　　处：《中华地方病学杂志》2013年第4期427-430,共4页Chinese Journal of Endemiology

基　　金：中央补助地方公共卫生专项资金地方病防治项目（2007-2011）

摘　　要：目的掌握宝鸡市克山病病情现状和消长趋势，为防治科研工作提供科学依据。方法选择凤县、千阳县、麟游县、陇县4个克山病病区县开展病例搜索，从县级医疗机构及乡（镇）卫生院近3年登记在册的全部心肌疾病病例中搜集克山病病例；选择千阳县、凤翔县、凤县、麟游县、陇县5个克山病病区县的13个克山病病村为监测点，进行克山病重点监测，对监测点所有调查对象进行全面临床体格检查和12导联心电图描记，依据《克山病诊断标准》判定。每个监测点（村）抽取10户居民家庭，采集1份主食小麦粮样和成人枕部发样进行硒水平测定。结果共搜索医疗机构32个，心肌病例746例，确诊慢型克山病17例。13个监测点共监测5723人，检出克山病患者65例，其中慢型克山病17例，潜在型克山病48例，总检出率为1．14％。发硒均值为0．420mg／kg；小麦硒均值为0．079mg／kg。结论宝鸡市克山病病情处于低发平稳态势，人群内环境硒水平已上升到非病区水平，但仍有克山病病例检出，应尽快建立病区人群内、外环境硒水平等克山病综合致病因素常态化监测机制。Objective To learn the existing state of Keshan disease and its trend in Baoji City, and to provide a scientific basis for control of the disease. Methods Feng, Qianyang, Linyou and Long Counties, the Keshan disease affected areas were selected to carry out the case study, and Keshan eases were searched from all registered cases of myocardial patients of the past three years at county-level medical institutions and hospitals of townships（tow.ns）. Thirteen villages affected by Kesban diseag in Qianyang, Fengxiang, Feng, Linyou and Long Counties were selected as monitoring points to carry out a intensified monitoring. All subjects were surveyed by comprehensive clinical physical examination and 12-lead ECG tracings,and they were diagnosed according to the Keshan disease diagnostic criteria. Ten households were selected randomly in each monitoring point（village）, and self-produced wheat samples and adult subject＇s occipital hair samples were collected for detecting selenium levels. Results Seven hundred and forty-six cardiac cases which containing 17 cases of chronic Keshan disease were discovered in 32 medical institutions, and there were no acute and subacute type of Keshan disease patients. Five thousand seven hundred and twenty-three subjects were examined in the 13 monitoring sites, and 65 cases of Keshan disease were diagnosed which including 17 cases of slow and 48 cases of potential Keshan disease, and no acute or subacute case was found. The total detection rate was 1.14%, and the detection rate ranged from 0 to 2.86%. Hair selenium mean was 0.420 mg/kg; wheat selenium mean was 0.079 mg/kg. Conclusions The Keshan disease detection rate of Baoji City is at a low level. The selenium level of local residents has reached the level of non-endemic area. Constant detection of patient with Keshan disease means various control measures should be reinforced. The comprehensive monitoring program, such as monitoring people＇s in vivo and in vitro selenium level and others, should be established as soon as po

关 键 词：克山病 监测评估 硒 

分 类 号：R542.3[医药卫生—心血管疾病]