2008～2012年重庆市克山病患者临床特征与地区分布情况  

Keshan Disease in Chongqing City during 2008-2012: Clinical Characteristics and Geographical Distribution

作　　者：吴成果[1] 黄文利[1] 罗兴建[1] 李心术[1] 肖邦忠[1] 

机构地区：[1]重庆市疾病预防控制中心,重庆400042

出　　处：《中国循证医学杂志》2014年第3期265-267,共3页Chinese Journal of Evidence-based Medicine

摘　　要：目的分析2008～2012年重庆市克山病患者临床特征与地区分布，为克山病的预防和控制提供数据。方法调查2008～2012年重庆市梁平、石柱、丰都、垫江、万州5个区、县的克山病患者情况，包括病历、体格检查和实验室检查，分析其临床特征和地区分布。结果共纳入58例克山病患者，分布在梁平（21例）、石柱（25例）、丰都（11例）、垫江（1例）4个区县。58例患者中，16例为潜在型，42例为慢型。患者平均年龄为54．91±15．53岁，以60岁组（32．76％）为主。患者主要特征表现为心界增大（36．76％）、第一心音减弱（22．41％）、收缩期杂音（10．34％）和心律不齐（8．62％）等，98．28％出现心电图异常，包括窦性心律（37．93％）、完全性右束支传导阻滞（25．86％）、ST—T改变（24．14％）、左心室肥大（15．52％）、心房颤动（13．79％）、偶发室性早搏（10．34％）、T波改变（10．34％）、实性心动过缓（8．62％）和不完全性右束支传导阻滞（6．90％）。X线片结果显示，心脏扩大比例为82．76％，轻度扩大、中度扩大和重度扩大者分别占46．55％、27．59％和8．62％。结论近来年重庆市克山病患者以慢型克山病为主，年龄较大．临床症状以心脏扩大为主．心电图异常检出率较高。Objective To analyze the clinical characteristics and geographical distribution of Keshan disease in Chongqing city for prevention and disease control. Methods We collected the clinical data of patients with Keshan dis- ease from 2008 to 2012 in Liangping, Shizhu, Fengdu and Dianjiang counties as well as Wanzhou district of Chongqing city including the medical history＇, physical examination, results of laboratory tests to analyze the clinical characteris- tics and geographical distribution. Results Fifty-eight patients were included from Liangping （n=21）, Shizhu （n=25）, Fengdu （n=11） and Dianjiang （n=l）. The number of patients with potential and chronic Keshan disease was 16 and 42, respectively. The average age of patients was 54.91±15.53 years. The proportion above age 60 was 32.76% and below age 10 was 3.45%. The patients had main clinical signs as heart enlargement （36.76%）, low-weak first heart sound （22.41%）, systolic murmur （10.34%）, arrhythmia （8.62%）, etc. Abnormal ECG detection rate was 98.28%, with common types fol- lowed by sinus rhythm （37.93%）, complete right bundle branch block （25.86%）, ST-T changes （24.14%）, left ventricular hypertrophy （15.52%）, atrial fibrillation （13.79%）, occasional ventricular premature （10.34%）, T changes （10.34%）, sinus bradycardia （8.62%）, and incomplete right bundle branch block （6.90%）. X-ray results showed that heart enlargement ac- counted for 82.76%. The ratios of mild, moderate and significant expansion of the heart were 46.55%, 27.59%, and 8.62%, respectively. Conclusion In recent years, most patients with Keshan disease in Chongqing are chronic type at older age. The main clinical symptom is heart enlargement with high abnormal ECG detection rate.

关 键 词：克山病 临床特征 地区分布 重庆市 

分 类 号：R542.3[医药卫生—心血管疾病]