2009年青海省兴海县儿童大骨节病病情及影响因素调查

Investigation of state and influence factors of children＇s Kaschin-Beck disease in Xinghai county of Qinghai province in 2009

目的调查青海省兴海县大骨节病相对活跃病区儿童大骨节病流行现状，以及当地儿童硒营养水平和家庭主食粮食T-2毒素污染水平。方法2009年对兴海县唐乃亥乡上、中、下3个村7—12岁儿童进行右手X线拍片，根据《大骨节病诊断标准》（GB16003—1995）进行诊断。同时采集拍片儿童的枕部发样、饮水以及主食粮食（小麦和／或面粉），2，3-二氨基萘荧光法测定其头发、饮水和主食粮食硒含量，酶联免疫吸附试验（ELISA法）检测主食粮食T-2毒素污染水平。结果儿童大骨节病X线总检出率为12．20％（31／254），其中下村X线检出率达到14．97％（22／147），上村X线检出率为9．52％（6／63），中村X线检出率为6．82％（3／44）。病区儿童内外环境硒水平普遍较低，头发、饮水、小麦、面粉硒含量分别为（0．250±0．136）mg／kg、（0．16±0．05）μg／L、（0．0045±0．0030）mg／kg、（0．0067±0．0116）mg／kg。病区儿童家庭主食粮食T-2毒素含量较高，小麦为（78．91±46．17）μg/kg；面粉为（47．47±46．47）μg／kg。结论青海省兴海县大骨节病相对活跃病区7—12岁儿童内外环境硒水平较低，而主食粮食T-2毒素污染水平较高，与当地儿童大骨节病病情分布基本一致。

Objective To investigate the present prevalence state of children＇s Kaschin-Beck disease （KBD） in Xinghai county of Qinghai province, a relative active KBD area in 2009, and to investigate their nutritional selenium level of local children and the T-2 toxin contamination level in their staple food. Methods Right hand X-ray photographs of children aged 7 - 12 in Shang, Zhong and Xia villages of Tangnaihai Countryside in Xinghai county were taken. X-ray diagnosis was carried out according to the ＂Diagnostic Criteria of Kashin Beck Disease＂ （GB 16003 - 1995 ）. Selected samples （children＇ s hair, drinking water and their staple food） were collected according to X-ray film taken. Selenium contents in hair, drinking water and staple food samples were measured by 2,3-diaminonaphthalene fluorescence, and T-2 toxin in staple food sample was detected with enzyme-linked immunosorbent assay（ELISA） kits. Results Total X-ray detection rate of children KBD was 12.20%（31/254） and KBD positive rate of children in Xia village was up to 14.97% （22/147）, Shang village was up to 9.52%（6/63）, and Zhong village was up to 6.82% （3/44）. The selenium level in children＇s body and outer environment was very low, namely, the selenium content in hair, drinking water, wheat and flour was （0.250± 0.136）mg/kg, （0.156 ± 0.046）μg/L, （0.0045 ± 0.0030）mg/kg, and （0.0067 ± 0.0116）mg/kg, respectively. The T-2 toxin level was relatively high in children＇s staple food, which was （78.91 ± 46.17）μg/kg in wheat and （47.47 ± 46.47） μg/kg in flour. Conclusions In relative active KBD areas of Xinghai county of Qinghai province, the children＇s selenium nutritional level is low, and the T-2 toxin contamination level in their staple food is relatively high, which is consistent with the distribution of local children＇ s KBD.