阿坝州壤塘县大骨节病区与四川成都地区儿童手部X线对比分析

Comparative analysis the roentgenography of children's hands in Rangtang County,Aba and Chengdu,Sichuan Province

目的通过与四川成都地区正常儿童手部X线片对比分析,了解四川阿坝州壤塘县地区儿童大骨节病发病情况及特点。方法选取4~16岁阿坝壤塘南木达乡异地育人学校学生与成都地区正常儿童对比分析。全部儿童进行双手X线摄片,X线片由来自四川省疾病预防控制中心、四川大学华西医院骨科、影像科、风湿免疫科及小儿外科共10人组成的阅片专家组共同判读。结果壤塘县儿童手部X线片显示锥形骨骺及异常改变多,14.6%的儿童出现食指、中指、环指近、中节多发、对称的异常改变,成都地区儿童未发现。结论说明在政府积极干预下,一方面壤塘县大骨节病表现非典型化,另一方面,其致病因子依然存在。探索大骨节病致病机理,寻求早预防,早诊断的方法,依然是我国骨科和地病学者需共同承担的责任。

Objective To study the prevalence situation of Kashin-Beck disease（KBD） in Rangtang County,Aba,by contrastive analyzing the X-ray examination of children′s hand in elementary school of Rangtang and Chengdu,Sichuan Province.Methods One hundred seventy-one students in Rangtang County and sixty four children in Chengdu were sampled for this investigation.The clinical examination was complished and the registration forms were filled out by senior orthopaedic surgeons.Every child was examined with X-ray on their both hands.Radiographs were read by 10 specialists to diagnose.The X-ray detective rate was counted and analyzed.Results Compared with the Chengdu,the incidence of cone-shaped epiphysis and symmetric multi-anomalies were higher in Rangtang.There were 14.6% children in Rangtang County whose hand X-rays showed the symmetric multi-anomalies in the middle and proximal phalanx of the index,middle and ring fingers,and no one in Chengdu.Conclusion The Kaschin-Beck disease displays the non-typification and the pathogenic factor of it was still active in Rangtang,under the intervention of the government.Consequently,exploring the pathogenesis mechanism,seeking the treatment and prevention method remains the awful burden for orthopedic surgeons and Endemic scholars.