2020年陕西省克山病病情监测结果分析  

Analysis of monitoring results of Keshan disease in Shaanxi Province in 2020

作　　者：郭鲜妮 刘婵 徐刚要[1] 杨正军[1] Guo Xianni;Liu Chan;Xu Gangyao;Yang Zhengjun(Research Laboratory of Kaschin-Beck Disease and Keshan Disease,Shaanxi Institute for Endemic Diseases Control,Xi'an 710003,China)

机构地区：[1]陕西省地方病防治研究所大骨节病克山病防治研究室,西安710003

出　　处：《中华地方病学杂志》2022年第9期746-749,共4页Chinese Journal of Endemiology

基　　金：公共卫生服务地方病防治项目(2020)。

摘　　要：目的掌握陕西省克山病病情现状,为当地克山病控制和消除评价提供科学依据。方法2020年5-11月,在陕西省29个病区县(区、市)的全部病区乡(镇)开展克山病病情监测工作,以病区村为单位,收集病区人口学资料,由村医线索调查疑似心肌病病例并收集患者近期门诊或住院临床检查资料;组织疑似病例进行临床查体、心电图描记、胸部X线和心脏超声检查。依据《国家卫生健康委关于印发重点地方病控制和消除评价办法(2019版)的通知》进行病区达标情况评估。结果全省共有病区乡(镇)174个、病区村2653个,病区村常住人口2819342人。共搜索出克山病疑似病例87例,克山病确诊病例29例,其中慢型克山病27例、潜在型克山病2例,未检出急型、亚急型克山病及病程<1年的新发病例。29例克山病病例心电图异常改变以ST-T改变、室性早搏、完全性右束支传导阻滞、左心室肥大、心房颤动多见,其中心电图单项改变占6.90%(2/29),两项改变占44.83%(13/29),3项及以上改变占48.28%(14/29)。胸部X线检查心胸比率正常者1例,轻、中、重度增大者分别有10、13、4例;心脏超声检查左心房增大者13例、左心室增大者15例、全心增大者6例。结论陕西省所有病区乡(镇)均达到国家克山病消除标准。应持续做好克山病监测,加强慢型克山病患者自我管理及潜在型克山病患者的随访观察,积极开展克山病患者治疗项目,提高患者生存质量。Objective To grasp the current situation of Keshan disease in Shaanxi Province,and to provide scientific basis for evaluation of local Keshan disease control and elimination.Methods From May to November 2020,Keshan disease surveillance was carried out in all the diseased townships(towns)of 29 diseased counties(districts,cities)in Shaanxi Province.The diseased village was used as the unit to collect the demographic data of the diseased areas,and the village doctor's clues were used to investigate suspected myocardial cases,and recent outpatient or inpatient clinical examination data of Keshan disease cases were collected;suspected cases were organized for clinical physical examination,electrocardiography(ECG),chest X-ray and echocardiography examination.According to"Notice of the National Health Commission on Printing and Distributing the Evaluation Measures for the Control and Elimination of Key Endemic Diseases(2019 Edition)",the diseased compliance status was assessed.Results There were 174 diseased townships(towns)and 2653 diseased villages in the whole province,with a permanent population of 2819342 people.A total of 87 suspected cases and 29 confirmed cases of Keshan disease were found,including 27 cases of chronic Keshan disease and 2 cases of latent Keshan disease.The acute and subacute Keshan disease and new cases with disease duration less than 1 year were not detected.The ST-T changes,premature ventricular contractions,complete right bundle branch block,left ventricular hypertrophy,and atrial fibrillation were the most common ECG changes in 29 cases of Keshan disease,and the single ECG change accounted for 6.90%(2/29),two changes accounted for 44.83%(13/29),and three or more changes accounted for 48.28%(14/29).There were 1 case with normal cardiothoracic ratio in chest X-ray examination,10,13,and 4 cases with mild,moderate and severe enlargement,respectively;13 cases with enlarged left atrium in echocardiography,15 cases with enlarged left ventricle,and 6 cases with enlarged heart.Conclusions All the di

关 键 词：克山病 监测 心电图描记 X线 评估 

分 类 号：R542.3[医药卫生—心血管疾病]