甘肃省非克山病病区扩张型心肌病调查

A survey on dilated cardiomyopathy in non-endemic areas of Keshan disease in Gansu Province

目的探讨甘肃省非克山病病区扩张型心肌病病情，为克山病病区克山病病情的控制评估提供依据。方法在甘肃省选取12个克山病病区县和2个非克山病病区县，每个县选取2个非克山病病区乡镇，每个乡镇选取1个自然环境和生产生活方式与克山病病区村相近的非克山病病区村作为调查点，现场进行临床查体、十二导联心电图描记，对疑似扩张型心肌病患者拍摄后前位2m距离胸部正位X线片或进行心脏超声检查。结果共调查28个非克山病病区村，临床查体和心电图检查13200人，其中心电图异常1518人，异常率为11．50％；检出扩张型心肌病1例，类潜在型克山病285例，总检出率为2．17％。类潜在型克山病患者男女性别比为1．00：1．07。克山病病区县的非病区村类潜在型克山病总检出率为1．98％（225／11354），低于非克山病病区县非病区村[3．25％（60／1846）]，差异有统计学意义（x2=12．096，P〈0．05）。结论非克山病病区扩张型心肌病及类潜在型克山病的检出，可为克山病病区病情控制评估提供依据。

Objective To investigate the situation of dilated cardiomyopathy in non-endemic areas of Keshan disease, and to provide the evidence for control and evaluation of Keshan disease. Methods Twelve endemic counties of Keshan disease and two non-endemic counties of Keshan disease were chosen, two non- endemic townships of Keshan disease were chosen from each county, then one non-endemic village of about 500 residents was selected as investigated site from each non-endemic township, the sampled villages natural environment, the production method and life style were similar to those of the village of Keshan disease. The residents of the villages sampled were surveyed by physical examination, electrocardiogram （ECG）; suspected dilated cardiomyopathy patients were conducted chest X-ray or cardiac echocardiography. Results The number of investigated villages was 28, and 13 200 people were surveyed by physical examination and ECG. The number of subjects with abnormal ECG was 1 518, and the rate of abnormal ECG was 11.50%. One patient with dilated cardiomyopathy and 285 patients with quasi-latent Keshan disease were found, the total prevalence was 2.17%. The proportion of quasi-latent Keshan disease between male and female was 1.00 ： 1.07. The prevalence （1.98%） of quasi- latent Keshan disease in villages of endemic counties was lower than that （3.25%） of the villages in non-endemic counties, and the difference was statistically significant （X2 = 12.096, P 〈 0.05）. Conclusion The prevalence of dilated cardiomyopathy and quasi-latent Keshan disease in non-endemic areas of Keshan disease can be used as references in the evaluation of Keshan disease in the endemic areas of Keshan disease,which may provide evidence for Keshan disease control and evaluation.