青海省大骨节病病情回顾分析

Prevalence state of Kashin-Beck disease in Qinghai Province: a retrospective analysis

目的汇总青海省3个大骨节病病区自1982-2005年的监测结果,分析大骨节病的发生、发展和影响其病情消长的相关因素。方法按全国大骨节病监测方案的要求,对贵德、兴海、班玛3个监测点7～12岁儿童进行流行病学、临床检查及右手X线拍片。采集发、粮、土等样品,进行禽硒量测定。结果贵德、兴海、班玛病区大骨节病临床、X线检出率分别在0～55．78％、11．37％～59．20％;0～48．68％、25．86％～50．38％;0～63．38％、0～52．63％。病区大骨节病病情缓慢下降,有一定的年度波动。硒测定结果表明,兴海、贵德大骨节病病区内外环境硒水平明显升高。结论兴海、贵德病区,大骨节病病情严重、活跃,班玛病区大骨节病自然消退。病区居民食用自产粮以及粮食收割、储藏不科学与大骨节病密切相关。

Objective To sum up the data from surveillance on Kashin-Beck disease（KBD） in the years of 1982 through 2005 in three KBD regions of Qinghai Province in order to analyze relative factors affecting prevalence state of KBD. Methods According to the requirements of National Survey Scheme on KBD, clinical examination and X-ray photography were performed in local children aged 7 - 12 year old, meanwhile selenium contents in hair, food and soil were also detected. Results In KBD regions of Guide, Xinghai, Banma, the KBD prevalence rate fluctuated from 0 to 55.78%, 0 to 48.68%, 0 to 63.38%,respectively; the X-ray detectable rate ranged from 11.37% to 59.20%, 25.86% to 50.38%, 0 to 52.63%,respectively. The prevalence rate declined very slowly with a bit of fluctuation. Selenium detection identified an increase of selenium level both inside body and in the environment. Conclusions The prevalence state is active and serious in Xinghai and Guide two KBD areas, however it decreased naturally in Banma KBD region from 1984 to 2005. Consuming the locally produced grains and unscientific reaping and storage of grain are possible two main factors affecting KBD.