西藏大骨节病历史重病区内外环境病情影响因素调查报告  

Investigation report on the influencing factors of internal and external environmental conditions of historical serious disease areas of kashin-beck in Tibet

作　　者：赵生成[1] 德吉央宗[1] 尼玛仓决[1] 土旦 龚弘强[1] 郭敏[1] ZHAO Shengcheng;Degyi Yangzom;Nimakura Decision;TU Dan;GONG Hongqiang;GUO Min(Center for Disease Control and Prevention of Tibet Autonomous Region,Lhasa850030,China)

机构地区：[1]西藏自治区疾病预防控制中心,拉萨850030

出　　处：《医学动物防制》2020年第10期1002-1004,1009,共4页Journal of Medical Pest Control

基　　金：中国疾病预防控制中心关于印发《全国大骨节病历史重病区内、外环境病情影响因素调查方案》(中疾控地病函[2018]1号)。

摘　　要：目的了解目前西藏大骨节病历史重病区及邻近非病区人群内外环境大骨节病病情影响因素的水平,明确影响因素的地理分布情况。方法在全区7个市(地)选择10个历史重病区县以及至今未达到消除目标的县。每个县选择1个历史重病区乡,每个病区乡选择1个重病区村和1个非病区村采集内外环境样品进行硒和真菌毒素(T-2)含量检测。结果西藏居民粮食硒含量水平较低,仅少部分家庭粮食中T-2毒素超标,可能与粮食存储方式有关,68%以上的儿童硒水平中等,27%的儿童硒水平处于硒缺乏边缘或缺乏。用SPSS 19.0、Excel 2010等软件进行描述性、相关性、一致性分析,不同地区之间内外环境影响因素差异无统计学意义。结论西藏大骨节病流行区土壤、青稞总体上处于低硒水平。环境各要素硒含量、真菌毒素(T-2)除外购粮食外仍处于低硒水平或缺硒边缘状态。由此提示,增加外源性高硒食物的摄入,改善当地居民的膳食结构,提高人群硒摄入量,特别是学龄儿童硒摄入量,仍是预防和控制大骨节病病情的基本对策。Objective To understand the current levels of influencing factors of internal and external environmental conditions of kashin-beck disease(KBD)in the historical serious disease areas and the adjacent non-affected areas in Tibet,and to clarify the geographical distribution of influencing factors.Methods A total of ten counties with historical serious disease and which didn’t reach the elimination goal so far were selected from seven cities(prefectures)in the whole region.In each county,one township of historical serious disease was selected,and one village of serious disease and one of no disease were selected from each township to collect the internal and external environmental samples for selenium and fungal toxin(T-2)content detection.Results The selenium content level of Tibet residents was relatively low,and only a small number of family grains contained excessive T-2 toxins,which may be related to the way of grain storage.More than 68%of children had a moderate selenium level,and 27%were at the edge of or suffered from selenium deficiency.SPSS 19.0,Excel 2010 and other software were used for descriptive,correlation and consistency analysis.There was no statistically significant difference between the internal and external environmental factors in different regions.Conclusion The soil and highland barley in the endemic areas of KBD in Tibet are at low selenium level.The selenium content of all environmental factors and fungal toxins(T-2)are still at low selenium level or at the edge of selenium deficiency except the purchased grains.Therefore,it is suggested that increasing the intake of exogenous foods with high selenium,improving the dietary structure of local residents,and increasing the selenium intake of people,especially that of school-age children,are still the basic countermeasures for the prevention and control of KBD.

关 键 词：大骨节病 环境 影响因素 硒 T-2毒素 

分 类 号：R684.1[医药卫生—骨科学]