内、外环境硒营养水平与克山病发病关系的研究

Relationship between the environment selenium nourishment level and the incidence of Keshan disease

目的探讨克山病病区内、外环境硒水平以及与克山病发病的关系.方法分别采集病区、非病区水,以及居民食用粮和病区、非病区人群头发、血清及尿样,用荧光法测定样品硒含量;并观察全省40年克山病病情动态变化,观察硒水平与克山病发病的关系.结果克山病病区水硒、土壤硒含量低于非病区;居民食用粮(小麦、玉米、瓜干)硒含量显著低于非病区(P＜0.01);克山病病区水、土中硒含量与当地粮食中硒含量成正相关关系.克山病患者发硒、血清硒、尿硒含量均显著低于病区健康人和非病区健康人(P＜0.01),病区健康人的血清硒、尿硒水平低于非病区健康人,发硒也有降低趋势.从1976～2004年克山病病区居民食用小麦、玉米硒含量逐渐增高,克山病患者头发、血清及尿液硒含量逐渐增高,克山病患病率逐渐降低.结论克山病发生于低硒地区,病区居民机体硒营养水平与克山病患病率之间呈一定的负相关关系.缺硒可能是克山病发生的地区性条件致病因素.

Objective To study the Keshan disease （KSD） patients＇ selenium nourishment levels and the connectiml of Inner, Outer environment selenium level and the incidence of KSD in endemic areas. Methods We selected water, soil, food, hair, blood and urine in KSD areas and in non- KSD areas respectively, anti determined the content of Se in the above samples. We observed the dynamic changes of Shandong KSD for 40 yeats and studied the connection of Se level and the incidence of KSD. Results In KSD areas, water Se, soll Se, wheat Se, corn Se and potato Se are signifeantly lower than that of non - KSD areas （ P 〈 0.01 ）, and the water Se , soil Se are positive related to the food Se. In KSD areas, the patients＇ levels of hair Se, blood Se and urine Se are significantly lower than that of healthy people in non- KSD areas （ P 〈 0.01）. From 1976 to 2004, tile residents＇ food Se （wheat and corn） gradually increased in KSD areas, the patients＇ hair Se, blood Se and urine Se were gradually increased, too. And the incidence of KSD was gradually decreased. Conclusions The KSD occurs in Se deficiency areas, and the residents＇ Se nourishment level is negative related to the incidence of KSD in KSD areas. So we think that Se - deficiency might be one of the important factors for the incidence of KSD.