山西省4县克山病控制和消除现况调查

Investigation on status of Keshan disease control and elimination in 4 counties of Shanxi Province

目的掌握山西省克山病病情,评估克山病控制和消除现况。方法选择吉县、永和、石楼、交口为调查县,开展全县范围的克山病病例搜索,再在每县选择2个病区乡,每乡选择一个病区村为调查点开展重点调查,每村选择400人左右,开展临床查体和心电图描记;对疑似克山病患者拍摄心脏后前位2米X光胸片并进行心脏彩色超声检查。结果病例搜索未发现克山病病例。共检查3538人,检出克山病80例,总检出率22.61‰。其中慢型克山病11例,检出率3.11‰,患病率0.12‰;潜在型克山病69例,检出率和患病率均为19.50‰。检出异常心电图319例,异常率9.02%。克山病人心电图异常改变以完全性右束枝传导阻滞和ST-T改变为主,分别占到总异常项次的37.04%和12.96%。克山病病例男女性别比为1:0.74。调查期间无新发急型、亚急型克山病病人。结论以县为单位,石楼、永和、交口实现控制目标;吉县未实现控制目标。

Objective To master the Keshan disease states in Shanxi Province, to assess the status of Keshan disease control and elimination. Methods To select Ji, Yonghe, Shilou and Jiaokou County as survey counties. First, we carried out a cases search of Keshan disease in each county. Then two epidemic townships were chosen in each county and 1 village was chosen in each township to carry out major investigation. About 400 residents over 3 years old were sampled to carry out clinical examination and electrocardiography in each village, and the suspected Keshan disease patients were selected to perform posteroanterior chest X- ray of 2 m and heart color sonography. Results No Keshan patient was found in case search. Total 3 538 residents were investi- gated, and 80 Keshan disease patients were detected with total detection rate 22.61%o. Out of the 80 patients, 11 cases were chronic with the detection rate 3.11%o and the prevalence rate 0.12%o, 69 cases were potential with the detection rate and the prevalence rate 19.50%o. 319 cases were detected to be abnormal electrocardiograms, with abnormal rate 9.02%. Abnormal electrocardiogram changes in patients with Keshan disease mainly showed complete right bundle branch block and ST-T change, with the abnormal rate 37.04% and 12.96% respectively. Contrast of male and female was 1 ： 0.74. There are no acute and sub -acute cases in the whole period of survey. Conclusions Take the county as a unit, Shilou, Jiaokou and Yonghe counties have achieved national control target, and Ji County has not.