四川省2011～2013年克山病调查结果分析

Investigation of Keshan disease in Sichuan in 2011～2013

目的了解补硒措施结束后四川省克山病病区现状,为四川省克山病预防控制提供科学依据。方法按统一调查方案对选定的冕宁县、西昌市、大竹县等5县的调查点内常住人口进行问卷调查,临床查体,描记十二导联心电图,疑似病例摄2 m后前位X线胸片或心脏超声检查。结果 5县(市、区)3年间未发现急型和亚急型克山病例。在30个调查点共调查14295人,其中2011年慢型克山病检出率0.37%(19/5111),潜在型克山病检出率0.37%(19/5111);2012年慢型克山病检出率0.15%(7/4596),潜在型克山病检出率0.20%(9/4596);2013年慢型克山病检出率0.11%(5/4588),潜在型克山病检出率0.26%(12/4588);慢型克山病检出呈下降趋势。川西南片区慢型克山病检出率0.34%(30/8947),潜在型克山病检出率0.30%(27/8947);川东片区慢型克山病检出率0.02%(1/5348)例,潜在型克山病检出率0.24%(13/5348);川西南片区的检出率高于川东片区的检出率。高年龄段检出多于低年龄段检出,无性别差异。结论补硒干预仍然是切实可行的预防措施。下一步应在西南片区建立健全克山病防治长效机制,逐步建立克山病防治网。

Objective To find out the prevalence of Keshan disease（KD） after the end of the selenium measures, in order to pro- vide evidence for prevention in Sichuan province. Method Based on the uniform surveillance program, the residents in 5 counties such as Mianning, Xichang and Dazhu were surveyed. Results 5 counties （ city, district） found no acute and sub acute KD cases in three years. Investigated 14 295 people in the 30 survey spots, in 2011 the chronic KD detection rate was 0.37% （ 19/5111）, latent KD detection rate was 0.37% （19/5111）, in 2012 the chronic KD detection rate was 0.15% （7/4596）, latent KD detection rate was 0.20% （9/4596）, in 2013 the chronic KD detection rate was 0.11% （5/4588）, latent KD detection rate was 0. 26% （ 12/4588）, chronic KD were decreased. In the southwest area, the chronic KD detection rate was 0.34% （30/8947）, latent KD detection rate was 0.30% （27/8947）, in the east area, the chronic KD detection rate was 0.02% （ 1/5348）, latent KD de- tection rate was 0.24% （13/5348）, the detection rate in the southwest area was high. The high age were more than low age. Gender had no significant effect on the detection. Conclusions Selenium intervention is still feasible prevention measures. The next step should establish and improve the long-term mechanism of KD in the southwest area, gradually establish the prevention network of Keshan disease.