2011年三门峡市慢型克山病与扩张型心肌病病情监测结果对比分析

Comparative Analysis on Surveillance Data of Keshan Disease and Dilated Cardiomyopathy,Sanmenxia City,2011

目的通过克山病病情调查和非克山病病区扩张型心肌病病情调查,探讨两种疾病患病情况及主要诊断方法的区别和意义。方法 2011年选择三门峡市克山病病区灵宝市开展克山病调查,选择三门峡市非克山病病区陕县开展扩张型心肌病调查;对调查对象进行临床查体和十二导联心电图描记,对疑似克山病或扩张型心肌病患者进行心动超声检查及拍摄后前位2m距离胸部正位X光片。结果调查受检率两县均大于80%,慢型克山病、扩张型心肌病病人检出率差异无统计学意义(P>0.05),克山病调查点心电图异常检出率高于扩张型心肌病调查点(P>0.01),两县心电图单项异常率差异有统计学意义的有8项,克山病调查点X线胸片增大率显著大于扩张型心肌病调查点(P<0.01),两县X线心胸比差异无统计学意义(P>0.05),两县超声心动图单项改变无差异。结论慢型克山病和扩张型心肌病的检出率相近;心电图异常检出率结果提示克山病病区人群心肌损害程度大于扩张型心肌病调查点;X线胸片检查提示克山病病区疑似病人心脏代偿性增大大于扩张型心肌病调查点,但心脏增大程度无明显差别。

Objective To investigate Keshan disease（KD） and dilated cardiomyopathy（DCM） in non Keshan disease endemic areas,so as to explore the difference and significance of the two diseases and the main diagnostic methods. Methods Lingbao and Shanxian counties were chosen to carry out the survey,as KD and non-KD endemic area in Sanme- nxia city respectively 2011. In the survey, clinical examination and 12 lead echocardiogram（ECG） tracings were used, and echocardiography examination and X-rays chest radiography were taken of suspected cases. Results In this survey, the examination rate of the two coumtries was both more than 80%,the detection rate of chronic KD and DCM had no signifi- cant difference （ P 〉0. 05） ,ECG abnormal detection rate of KD investigation spots was significantly more than DCM in- vestigation spots （ P 〈0.01） ,nine ECG individual anomalies of the two countries had significant difference. X-rays chest increasing rate of KD investigation spots was significantly more than DCM investigation spots （ P 〈0. 01） ;X-ray cardio thoracic ratio of the two counties had no significant statistical difference （ P 〉0.05）, echocardiography individual of the two countries had no statistically significant difference. Conclusion The detection rate of chronic KD and DCM is simi Iar;ECG abnormality detection rate results suggest that myocardial damage in KD endemic population is more serious than DCM survey spots; X ray chest examinations show cardiac compensatory of suspected patients in KD endemic increase greater than the DCM survey spots, but the degree of cardiac enlargement has no significant difference.