2021年陕西省克山病监测结果分析  

Analysis of monitoring results of Keshan disease in Shaanxi Province in 2021

作　　者：郭鲜妮 刘婵 杨正军[1] 徐刚要[1] GUO Xian-ni;LIU Chan;YANG Zheng-jun;XU Gang-yao(Research Laboratory of Kashin-Beck Disease and Keshan Disease,Shaanxi Institute of Endemic Diseases Control,Xi'an,Shaanxi 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,陕西西安710003

出　　处：《中国地方病防治》2022年第6期493-495,共3页Chinese Journal of Control of Endemic Diseases

摘　　要：目的掌握陕西省克山病病情现况,及时发现新病例和明确防治工作重点,为陕西省克山病控制和消除评价提供科学依据。方法2021年在陕西省29个病区县的全部病区乡开展克山病监测工作,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、心脏超声和X线胸片检查。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》对病区达标情况进行评估。结果全省共有病区乡175个、病区村2358个,病区村常住人口2690905人。共搜索出疑似病例42例,确诊克山病18例,其中慢型17例、潜在型1例,未检出急型、亚急型病例及病程小于1年的新发病例。克山病患者心电图异常改变以室性早搏、心室肥大、ST-T改变、完全性右束支传导阻滞等多见,且94.44%(17/18)确诊患者都有两项或两项以上心电图改变;确诊克山病病例中心胸比率正常者1例,轻、中、重度增大者分别有2、4、11例;心脏超声检查左心房增大10例、左心室增大9例、全心增大7例。共复核347例在册克山病病例,214例患者病情未发生变化,7例由潜在型转为慢型,7例由慢型转为潜在型,49例转为正常,误诊患者68例,死亡患者2例。结论陕西省所有病区乡持续达到国家克山病消除标准。建议进一步加强病区居民健康教育和克山病防治知识宣传;加强监测力度及基层人员业务知识培训,确保克山病调查工作质量。Objective To master the current situation of Keshan disease in Shaanxi Province and find new cases timely and clarify the focus on prevention and control,and to provide scientific basis for the control and elimination evaluation of Keshan disease in Shaanxi Province.Methods In 2021,Keshan disease surveillance was carried out in all diseased townships of 29 diseased counties in Shaanxi Province.Taking the diseased village as the unit,the demographic data of the diseased area were collected,the suspected cases of cardiomyopathy were investigated as the clues by the village doctors,and the recent outpatient or inpatient clinical examination data of the suspected cases were collected.The suspected cases were organized for clinical physical examination,electrocardiography,chest X-ray and echocardiography.According to the"Notice of the National Health Commission on Printing and Distributing the Evaluation Methods for the Control and Elimination of Key Endemic Diseases(2019 Edition)",the diseased compliance status was assessed.Results There were 175 diseased townships and 2358 diseased villages with a permanent population of 2690905 people in the whole province.A total of 42 suspected cases were found,and 18 cases were confirmed as Keshan disease,including 17 cases of chronic Keshan disease and 1 case of latent Keshan disease.The acute and subacute Keshan disease and new cases with disease duration less than 1 year were not detected.The premature ventricular contractions,ventricular hypertrophy,ST-T changes and complete right bundle branch block were the most common ECG changes and the two or more ECG changes accounted for 94.44%(17/18)in Keshan disease patients;In the confirmed cases of Keshan disease,there were 1 case with normal cardiothoracic ratio in the confirmed Keshan patients,2,4 and 11 cases with the mild,moderate and severe enlargement,respectively;There were 10 cases of left atrial enlargement,9 cases of left ventricular enlargement,and 7 cases of the whole heart enlargement.A total of 347 registered Keshan

关 键 词：克山病 监测 心电图 X线 评估 

分 类 号：R542.3[医药卫生—心血管疾病]