2012年内蒙古阿荣旗克山病病情监测分析

Surveillance and control of Keshan disease in Arong Banner, Inner Mongolia in 2012

目的调查内蒙古克山病历史重病区阿荣旗克山病病情消长趋势，为科学指导克山病防治工作提供流行病学依据。方法2012年，按《全国克山病病情监测方案》要求，选择阿荣旗的2个村为监测点，对监测点人群进行临床检查、心电图描记；对克山病疑似病例拍摄后前位胸部X线片和超声心动图检查；同时调查居民经济收入及主食结构等情况。结果共调查833人，心电图异常率为7．92％（66／833）；拍摄胸部X线片45人。心脏增大检出率为20．00％（9／45）人，其中轻度增大占8．89％（4／45），中度增大占4．44％（2／45），重度增大占6．67％（3／45）。克山病患者检出率为132．05／万（11／833），其中潜在型克山病为72．03／万（6／833），慢型克山病为60．02／万（5／833）。克山病病例心电图异常以ST-T改变和右束支传导阻滞多见，分别占100．00％（11／11）和63．64％（7／11）；频发室性期前收缩2例，占18．18％（2／11）；I°房室传导阻滞1例，占9．09％（1／11）；完全性左束支传导阻滞1例，占9．09％（1／11）。阿荣旗人均年收入8100元；2个监测村居民主食为大米、面粉和其他杂粮，其中大米占70％。80％，面粉占15％～25％；购外地粮占95％。结论阿荣旗克山病病情已经控制在国内较低水平，但新的潜在型、慢型克山病以缓慢、渐近、逐渐累积的形式发生，其发病受生活水平及膳食结构因素影响，今后应密切关注克山病病情，做好克山病的防治工作。

Objective To survey the Keshan disease conditions and its trend in the historical serious illness areas of the disease in Arong Banner, and to provide epidemiological evidence for scientific prevention and control of Keshan disease. Methods According to the requirements of ＂National Keshan Disease Surveillance Program＂, two villages in 2 townships of Arong Banner were selected as monitoring sites in 2012, population in monitoring sites was conducted clinical examination and electrocardiogram （ECG） tracings; suspected cases of Keshan disease were conducted chest X ray and ultrasound heartbeat graph examination. At the same time, residents income and staple food structure were investigated. Results The abnormal rate of ECG was 7.92% （66/ 833）. The detection rate of cardiac enlargement was 20.00% （9/45） by chest X ray, in which a slight increase was 8.89% （4/45）, moderate increase was 4.44% （2/45） and severe increase was 6.67% （3/45）. The detection rate of Keshan disease patients was 132.05/10 000 （11/833）, including latent Keshan disease [72.03/10 000 （6/833）] and chronic Keshan disease [60.02/10 000 （5/833）]. In the ECG abnormal changes of Keshan disease cases, ST-T change and right bundle branch block were common, accounting for 100.00% （11/11） and 63.64% （7/11）, respectively; frequent ventricular premature contraction was 2 cases, accounting for 18.18% （2/11）, degree I ° atrioventricular block and complete left bundle branch block was both 1 case, accounting for 9.09% （1/11）. Annual per capita income in Arong Banner was 8 100 yuan; dweller staple food was rice, flour and other grain crops, rice accounted for 70% - 80%, flour 15% - 25% and purchased non-local grain accounted for 95%. Conclusions Keshan disease has been under control at a lower level in Arong Banner, but new latent and chronic Keshan disease occur slowly, gradually and gradually accumulated; life quality and dietary structure have influence on the incidence. In the future, we should pay more attention to Keshan disease and do a good job on prevention and control of Keshan disease.