2007年山东省克山病病区居民患病情况调查分析

Survey and analysis on inhabitants in Keshan disease endemic areas of Shandong Province in 2007

目的掌握2007年山东省克山病病情现状，了解内、外环境硒营养水平，为防治科研工作提供科学依据。方法在8个克山病病区县（市）选择20个病村，每村受检率不低于85％，对所选择的人群进行临床查体和心电图描记，可疑心脏异常者行X线胸部后前位摄片，采集被调查者的头发和食用的小麦、玉米、地瓜干进行含硒量测定。结果共调查病区居民2613人，检出克山病91例，总检出率为3．48％。其中潜在型克山病82例，占90．1％（82／91），检出率为3．14％（82／2613）；慢型克山病9例，占9．9％（9／91），检出率为0．34％（9／2613），无急型、亚急型克山病病例检出。检出异常心电图368例，异常心电图检出率为14．08％（368／2613）。对113例可疑心脏异常者进行X线胸部摄片检查，心脏增大者57例，检出率50．44％（57／113）。采集头发217份，小麦228份、玉米214份、瓜干190份，测得含硒量依次为（0．406±0．090）、（0．026±0．009）、（0．023±0．010）、（0．024±0．006）mg／kg。结论目前山东省克山病病情处于稳定态势，病区居民发硒接近硒适宜地区水平，粮食含硒量仍处于较低水平。

Objective To investigate the current condition of Keshan disease（KD）, and inner and outer environmental selenium（Se） levels in Shandong Province, in order to provide scientific evidence for the research, prevention and control work. Methods Inhabitants from 20 villages of 8 counties in KD endemic areas were selected as subjects undergoing general physical examination and electrocardiogram （ECG）. Suspicious cases were followed up by chest X-ray radiographs. Meanwhile the Se contents in hair, wheat, corn and sweet potato were measured. Results Ninety one patients with KD, including 82 with latent KD and 9 with chronic KD, were screened out of 2613 inhabitants. The total incidence of KD was 3.48%（91/2613）, while the incidence of latent and chronic KD was 3.14% （82/2613） and 0.34%（9/2613） respectively. No new cases of acute or sub-acute KD were found. A total of 368 abnormal ECGs were discovered and the rate of abnormal ECG detected among surveyed population was 14.08%（368/2613）. Out of 113 suspects who took X-ray, 57 cases had cardiomegaly. In 217 samples of hair, 228 samples of wheat, 214 samples of corn and 190 samples of sweet potato that were collected, the Se contents were determined by fluorescence. The average Se content in hair, wheat,corn and sweet potato were （0.406 ± 0.090）, （0.026 ± 0.009）, （0.023± 0.010）, （0.024 ± 0.006）mg/kg respectively. Conclusions Current condition of KD in Shandong Province remains relatively stable. Se content was increased in the hair, nearly achieving the level in normal areas, but remains low in food.