山东省莒县克山病病区居民和非病区城镇居民异常心电图对比分析

Comparison of abnormal electrocardiography of patients with Keshan disease in endemic area and non-endemic urban area in Ju County of Shandong Province

目的 对比观察山东省莒县克山病病区居民和非病区城镇居民心电图变化情况,为克山病防治提供科学依据.方法 2013年,在山东省莒县克山病病区抽取桑园、安庄、碁山、龙山4个乡（镇）,每个乡（镇）选择1个病区村,每个村抽取常住居民至少200人;莒县非病区城区共有36个居民小区,在东、西、南、北4个方位各抽取1个居民小区,每个居民小区抽取常住居民至少200人作为对照组,对全部抽取居民进行心电图检查.克山病诊断参照《克山病诊断标准》（WS/T 210-2011）.结果 在克山病病区,共进行心电图检查964例,检出异常心电图143例,总异常检出率为14.83％;城镇居民心电图检查926例,检出异常心电图78例,总异常检出率为8.42％,两组比较差异有统计学意义（χ2=18.80,P＜ 0.01）.克山病病区居民异常心电图中符合《克山病诊断标准》8项异常心电图改变的有93例,异常检出率为9.65％;城镇居民则有37例,异常检出率4.00％,病区居民异常检出率明显高于非病区城镇居民（χ2=23.55,P＜0.01）.结论 山东省莒县克山病病区居民处于高异常心电图检出状态,仍受克山病致病因子的威胁,应进一步加强克山病防控.

Objective To provide a scientific basis for prevention of Keshan disease by observing the changes of electrocardiogram in residents from Keshan disease area and urban residents in Ju County.Method In 2013,four countries （towns） of Sangyuan,Anzhuang,Qishan and Longshan were selected as the investigation sites across the Keshan disease areas in Ju County of Shandong Province,one village was selected in each country （town）,no less than 200 people were chosen from each village.There were 36 residential communities in urban area in Ju County,one residential community was selected from 4 positions （east,west,south and north） in urban area,no less than 200 non-endemic urban residents were chosen from each residential community as control,the electrocardiogram examination was conducted.According to the ＂Keshan Disease Diagnostic Standard＂ （WS/T 210-2011）,Keshan disease was diagnosed.Results Among the 964 inhabitants investigated in Keshan disease area,143 cases showed abnormal electrocardiogram and the detection rate was 14.83%;in the 926 cases of urban electrocardiogram,78 cases showed abnormal electrocardiogram,abnormal rate was 8.42%,the difference was statistically significant （χ2 =18.80,P 〈 0.01）.There were 93 cases who met the 8 Keshan disease diagnostic criteria of abnormal electrocardiogram changes in the Keshan disease areas,abnormal rate was 9.65%;while there were 37 cases in urban residents,abnormal rate was 4.00%,the difference was statistically significant （χ2 =23.55,P 〈 0.01）.Conclusion These residents who have lived in Keshan disease endemic areas have a higher rate of abnormal electrocardiogram in Ju County of Shandong Province,they are still threatened by the causative factors of Keshan disease,and the authority should strengthen the prevention measures of Keshan disease.