四川省阿坝州控制大骨节病相关因素的病例对照调查  

A case-control study on Kashin-Beck disease-related factors in Aba of Slchuan Province

作　　者：曾婕[1] 邓佳云[1] 李津蜀[1] 李富忠[1] 陈敬[1] 简鸿帮[1] 黄慧[1] 陈开华[2] 秦胜超[2] 李莉 姚永强 晏兆政 罗尔伍 

机构地区：[1]四川省疾病预防控制中心地方病防治研究所大骨节病防治科,成都610041 [2]四川省阿坝州疾病预防控制中心 [3]四川省马尔康县疾病预防控制中心 [4]四川省金川县疾病预防控制中心

出　　处：《中华地方病学杂志》2013年第5期548-551,共4页Chinese Journal of Endemiology

基　　金：国家“十一五”科技支撑计划（2007BA125803）

摘　　要：目的调查影响四川省阿坝州大骨节病病情的相关因素。寻找有效防控措施。方法采用病例对照研究的方法，选取2009、2010年金川、马尔康县大骨节病监测点8-15岁儿童右手X线正位片阳性者作为病例组，同时以X线正位片阴性且与病例组人员同性别、同年龄、同村庄、同学校1：1配对儿童作为对照组，通过问卷方式调查相关防控措施落实情况。采集调查对象发样，用氢化物原子荧光光谱法检测发硒，统计分析影响大骨节病病情的相关因素。结果共调查64人。病例组和对照组各32人。所在学校主食结构（每周食用米饭次数）比较，差异无统计学意义（Z=-0．695，P〉0．05），副食结构比较，差异无统计学意义（肉类：Z=-1．270，P〉0．05；奶品：Z=-0．300，P〉0．05）；发硒水平比较，差异无统计学意义[（0．27±0．09）、（0．26±0．10）mg／kg，X^2=0．094，P〉0．05]；所在家庭人均年收入比较，差异无统计学意义（Z=-1．079，P〉0．05）；所在家庭主食结构（大米：X^2=1．024；面食X^2=1．636）、副食结构（肉类：Z=-1．231；奶品：Z=-0．603）比较，差异无统计学意义（P均〉0．05）。病例组中骨端阳性者主食面食的家庭比例（84．6％，11／13）高于对照组（59．4％，19／32，X^2=8．477，P〈0．05），而主食大米的家庭比例（61．5％，8／13）明显低于对照组（81.3％，26／32，X^2=5．529，P〈0．05）。结论补硒未能显示防病作用，彻底换粮可能是消除大骨节病危害的有效途径。Objective To investigate relevant factors to Kaschin-Beck disease（KBD）, and to find out effective countermeasures to the disease. Methods Children aged 7 - 16 whose fight hands X-ray films were positive or negative examined in the year 2009 and 2010 from KBD monitoring stations of Jinchuan and Maerkang Counties were selected. A case-control study was applied; questionnaires were used to investigate the implementing effectiveness of controlling measures, and relevant factors to controlling of KBD were analyzed. Results A total of 64 students were recruited in this research, and both the case and control groups consist of 32 students, respectively. The students staple structure（number of times of weekly consumption of rice, Z = - 0.695, P 〉 0.05）, non-staple food structure（Meat： Z =- 1.270, P 〉 0.05; Milk： Z =- 0.300, P 〉 0.05）, hair selenium levels [ （0.27 ± 0.09）, （0.26±0.10）mg/kg, X^2 = 0.094, P 〉0.05] were not significantly different. Where the per capita household income, the difference was not statistically significant（Z = - 1.079, P 〉 0.05）; staple food structure （Rice： X2= 1.024, P 〉 0.05; Pasta： X2= 1.636, P 〉 0.05） and non-staple food structure（Meet： Z =- 1.231, P 〉 0.05; Milk： Z = - 0.603, P 〉 0.05）. In bone-end-positive group, the proportion of families who often took homegrown pasta as main foods （84.6%, 11/13） was higher than that of control group （59.4%, 19/32,X^2= 8.477,P 〈 0.05）, however the proportion of families who often took rice as main foods was significantly lower than that of the control group（bone-end-positive group： 61.5%, 8/13; control group： 81.3%, 26/32,X^2 = 5.529, P 〈 0.05）. Conclusions Selenium has failed to show the effect of preventing KBD, thoroughly replacing homegrown-grain may be an effective way of eliminating KBD.

关 键 词：大骨节病 数据收集 病例对照研究 因素分析 统计学 

分 类 号：R684.1[医药卫生—骨科学]