广东、新疆中小学生及成人风湿性心瓣膜病流行病学调查

Epidemiological survey of rheumatic heart disease in schoolchildren in Guangdong and Xinjiang

目的了解广东与新疆中小学生风湿性心瓣膜病流行现状。方法采用整群抽样方法,2005～2006年分别在广东和新疆协作区部分中小学校开展以听诊和体检为主要手段的风湿性心瓣膜病普查,结合病历回顾、成人调查和9～12岁小样本甲组乙型溶血性链球菌(甲链)带菌率调查。结果各协作区中小学生风湿性心瓣膜病检出率为0,新疆成人风湿性心瓣膜病患病率(12.9‰)高于广东清新(2.2‰),新疆甲链阳性带菌率为9.8%～12.6%,高于广东的连洲(2.3%)和清新(3.9%)。结论新疆小学生甲链带菌率和成人风心病患病率均明显高于广东,提示新疆的风心病流行较广东严重。中小学生风湿性心瓣膜病患病率与1994年相比有下降趋势。

Objective To investigate the prevalence of rheumatic heart disease （RHD） among schoolchildren in Guangdong Province and Xinjiang Uygur Autonomous Region. Methods Using a cluster sampling method, an epidemiological survey of RHD was conducted in 16 682 primary and high school students by auscultation in Guangdong Province and Xinjiang Uygur Autonomous Region from 2005 to 2006. Review of the clinical records, RHD survey in adults, and examination of the positivity rate of group A β-hemolytic Streptococcus （GAS） by throat swab cultures in the students aged between 9 and 12 years in the sampled schools were also carded out. Results No RHD patient was found in the sampled population. In Xinjiang, the prevalence of RHD was 12.9%o among adults, higher than that （2.2%0） in Guangdong Province. The GAS-positive rate in the schoolchildren in Xinjiang ranged from 9.8% to 12.6%, higher than that in Guangdong （2.3%-3.9%）. Conclusion The GAS-positive rate among children and incidence of RHD in adults are higher in Xinjiang than in Guangdong. The prevalence of RHD among the schoolchildren shows a reduction compared with that in 1994.