2005年陕西省旬邑县克山病病情监测报告

Keshan disease surveillance in Xunyi County of Shaanxi Province in 2005

目的掌握陕西省克山病病情变化及环境因素的改变对克山病发病的影响,科学的指导和评价陕西省克山病防治和科研工作。方法在陕西省旬邑县土桥镇东曹村设立监测点,对全部常住人口进行临床检查、描记心电图,对克山病病人及可疑病例拍摄2 m后前位X线胸片。观察全县范围内急型、亚急型、慢型克山病的发病及转归情况。对监测点人群发硒、粮硒水平进行测定,调查病区人群经济水平及膳食结构。结果①2005年监测点东曹村无急型、亚急型克山病发病,潜在型、慢型克山病检出率分别为3．79％和0．35％;监测人群异常心电图检出率为11．38％,人均发硒(0．579±0．012)mg／kg,粮食硒(0．089±0．082)mg／kg。②2005年旬邑县无急型、亚急型克山病发病,自然慢型克山病发病率为0．53／万,慢型克山病患病率为2．86／万。结论陕西省旬邑县克山病病情总体处于平稳低发态势,但仍有相当数量的潜在型、慢型克山病新发病例出现,说明病区环境中仍然存在着与克山病有关的一些致病因素,并对病区人群构成潜在的威胁。因此,继续加强病情监测,仍是今后陕西省克山病防治工作的重点。

Objective To investigate Keshan disease situation and environmental factors affecting Keshan disease incidence, thus to provide the basis for scientifically guiding and evaluating the prevention and research. Methods Clinical examinations and electrocardiography were performed for the whole regular residents in Dongcao village of Tuqiao town in Xunyi County, among whom suspicious patients further underwent posterior X- ray. Also the incidence and transition of acute, subacute and chronic Keshan disease were observed. The content of selenium in grain and hair was determined. The income and dietary structure were investigated in the area. Results ① No acute and subacute Keshan disease patient were observed in the surveillance spots. The prevalence of latent and chronic Keshan disease was 3.79% and 0.35%, respectively. The rate of abnormal electrocardiogram was 11.38%. The content of selenium in hair and gra.in was（0.579± 0.012）mg/kg and （0.089 ± 0.082）mg/kg, respectively. ② No acute and subacute Keshan disease patients were observed in the whole county. The incidence rate of natural chronic Keshan disease was 0.53/10 000. Prevalence rate of chronic Keshan disease was 2.86/10 000. Conclusions Keshan disease in Xunyi County, in steadily low prevalence, sometimes appears with newly discovered patients with latent and chronic Keshan disease, indicating the disease-inducing factors threatening lacal residents still exist. Further surveillance on the disease is still a key in the prevention and treatment.