哈尔滨市克山病病区和病情底数现况调查

A cross-sectional study of regions and conditions of Keshan disease in Harbin

目的掌握哈尔滨市克山病病区范围、病情底数现况，为《全国地方病防治“十二五”规划》终期考核评估工作积累数据。方法2013年按《克山病诊断}（WS／T210—2011）标准，对哈尔滨市10个克山病病区县患者进行临床检查。2011—2015年，对全市10个克山病病区县（区、市）进行病区检测和病例搜索。参照《克山病病区判定和类型划分》、《重点地方病控制和消除评价办法》判定该病区类型及控制和消除情况，同时对所有克山病病区患者用全球卫星定位系统（GPS）进行定位。结果哈尔滨市现有2个克山病病区县，12个病区乡（镇）存在现患病例，患病人数为37人，12个病区乡（镇）均符合克山病轻病区标准；其他8个县（区、市）病区乡均符合克山病历史病区标准。各区、县（市）克山病组织管理指标得分均达到了消除标准85分及以上的要求；10个病区县（区、市）及所辖乡在技术指标上均达到消除技术标准；哈尔滨市实现了克山病的基本消除。通过卫星定位所有克山病现患的经纬度均集中在北纬45．1°～45．5°，东经127．7°-128．3°。结论哈尔滨市的克山病病区范围明显缩小，患病率下降，达到了“十二五”规划提出的基本消除克山病的指标。

Objective In order to accumulate data for the final evaluation and acceptance of the ＂Twelfth Five-Year Plan of National Endemic Disease Prevention and Control＂, we investigated the endemic scopes and basic situation of Keshan disease （KD） in Harbin. Methods According to the ＂Criteria for Diagnosis of Keshan Disease＂ （WS/T 210-2011 ）, we conducted clinical survey of KD prevalence in 10 KD endemic counties in Harbin in 2013. 2011 - 2015, we detected and searched for cases in 10 ward counties of Keshan disease. According to the ＂Delimitation and Classification of Keshan Disease Areas＂ and the ＂Evaluation of Endemic Disease Control and Elimination＂, we determined the regional type, the situation of control and elimination of the disease, at the same time all KD patients were positioned by global positioning system （GPS）. Results There were 2 KD endemic counties, 12 endemic townships, and 37 KD patients in Harbin. All 12 townships were the light endemic regions of KD. Other townships were conformed to be the history regions with KD. The management index scores of KD reached the elimination requirements which were more than 85 points in every region county （city）. Ten region counties got to technical standards for KD elimination. Harbin basically reached the index of KD elimination. The GPS satellite positioning of KD patients were concentrated in the 45.1 - 45.5 degrees north latitude, and 127.7 - 128.3 degrees east longitude. Conclusion The regions of KD endemic areas have narrowed down and the prevalence rate has declined significantly in Harbin, which have reached the basic elimination standards of KD by the ＂12th Five-Year Plan＂.