2007年陕西省黄陵县克山病病情监测报告

Surveillance on Keshan disease in Huangling County, Shannxi Province in 2007

目的了解2007年陕西省黄陵县克山病发病情况。方法将陕西省黄陵县克山病重病区店头镇3个村村民和腰坪乡中心小学学生作为监测对象进行心电图等检查，用以筛检克山病患者，并对全县已知潜在型克山病（简称潜克）和慢型克山病（简称慢克）患者进行X线胸片检查。荧光分光光度法检测病区患者、病区健康人群（内对照）、非病区健康人群（外对照）血硒及儿童发硒水平。结果店头镇和腰坪乡无急型、亚急型克山病发生，潜、慢克总检出率为3．92％（35／893），新发潜克1例，克山病患者心电图异常改变主要表现为ST—T改变。对全县潜、慢克患者83例进行X线胸片检查，心胸比例正常者27例，轻、中度增大者各20例，显著增大者16例。病区患者及内对照、外对照人群血清含硒量分别为（38．67±19．58）、（48．55±22．36）、（67．29±17．32）μg／L，组间比较差异有统计学意义（F=16．291，P〈0．01）；病区患者和内对照血硒明显低于外对照（P〈0．01），病区患者血硒明显低于内对照（P〈0．01）。店头镇、腰坪乡中心小学儿童和非病区儿童发硒水平分别为（0．376±0．101）、（0．372±0．085）、（0．436±0．085）μg／L，组间比较差异有统计学意义（F=17．032，P〈0．01）；病区儿童发硒均明显低于非病区（P〈0．01）。结论2007年陕西省黄陵县克山病检出率有所下降，而潜克仍有新发，可能与病区居民仍处于低硒状态有关。

Objective To monitor the prevalence of Keshan disease in Huangling County, Shaanxi Province in 2007. Methods All local residents in surveillance area of Keshan disease in Diantou and Yaoping Township of Huangling County, were surveyed and given overall examinations by electrocardiography. The patients of latent and chronic Keshan disease were examined by X-ray. Tile selenium contents in blood and hair were monitored by fluorospectrophotometry in surveillance and non-surveillance areas. Results No new case of acute or sub-acute patient was found. Latent and chronic patients detected accounted for 3.92% （35/893）. Only 1 case of new latent Keshan disease was newly found. Major feature of electrocardiographic abnormality was ST-T change. By X-ray, there were 27 cases with a normal heart, 20 cases with mild enlargement, 20 cases with medium enlargement, and 16 cases with marked enlargement. Serological selenium concentrations were （38.67 ± 19.58）, （48.55 ± 22.36）, （67.29 ± 17.32）μg/L, respectively in patients, internal and external controls（F = 16.291 ,P 〈 0.01 ）. Selenium contents of children＇s hair were （0.376 ± 0.101 ）, （0.372 ± 0.085 ）, （0.436 ± 0.085）μg/L, respectively（F= 17.032, P 〈 0.01 ）. Conclusions Cases of diagnosed Keshan disease were decreased compared with the previous years. There were new cases of latent Keshan disease in Huangling County, Shaanxi Province.