陕西省黄陵县克山病8年监测结果分析

Eight years follow-up study of Keshan disease in Huangling county,Shaanxi province

目的观察陕西省黄陵县1995～2002年克山病病情变化。方法在黄陵县的6个重病村设立监测点,全体居民均为监测对象,同时对全县慢型克山病(慢克)的发病情况进行监测,并对监测点3～15岁儿童内环境硒水平进行监测。结果(1)6个监测点8年共检出慢克病人20例,潜在型克山病病人(潜克)282例,新发潜克病人14例。1995、1997、1999、2000和2002年克山病的检出率分别为4.3%、3.6 %、7.5%、8.0 %和8.5 %;患病率为1.0 %、2.4 %、3.2 %、3.6 %和2.0 %;潜在型克山病的新发生率为55.6/万、53.5/万、19.5/万、0/万和25/万;(2)8年全县共确诊慢克病人62例,死亡22例,15例死于慢性充血性心力衰竭,7例死于猝死;(3)监测点3～15岁儿童发硒与非病区儿童比较,差异无显著意义。结论陕西省黄陵县监测点克山病的检出率呈缓慢上升态势,发病率呈平稳态势,但潜在型克山病仍有新发。

Objective To observe the dynamic changes for the state and related factors of Keshan disease. Methods Surveillance point of Keshan disease condition was set up in 6 villages where the disease occurs seriously in Huangling county and all local residents were treated as surveillance subjects. State and change of Keshan disease in the surveillance point were observed successively for 8 years from 1995 to 2002 and at the same time selenium （Se） levels in hair samples of children in age from 3 to 15 years were measured. Results （ 1 ） Total of 20 chronic, 282 potential and 14 new cases were diagnosed during the past 8 years in the 6 monitoring sites. The incidence of latent and chromic Keshan disease in 1995,1997,1999,2000 and 2002 was 4.3 %,3.6 %,7.5 %,8.0 %,and 8.5 %, respectively, the morbidity rate was 1.0 %, 2.2 %, 3.2 %,3.6 % and 2.0 %,respectively, The morbidity of latent Keshan disease were 55.6/ten thousand,53.5/ten thousand, 19.5/ten thousand,0/ten thousand and 25/ten thousand, respectively. （2） All over the county, total of 62 cases were diagnosed as chronic Keshan disease in the county in 8 years, 22 cases died, in which, 15 cases died form chronic congestive heart failure, 7 died at sudden death. （3） The hair selenium contents of cases from children in age of 3 to 15 year in the area of Keshan disease were not significantly different from those in the non-endemic area. Conclusions The rate of diagnosed Keshan disease is going up slowly, the incidence of Keshan disease is steady, but still has new cases of latent Keshan diseases in Huangling county, Shaanxi province.