河南省2011-2015年克山病监测

The surveillance data of Keshan disease from 2011 to 2015 in Henan province

目的监测河南省克山病病情,评估河南省克山病消除状况。方法按照国家克山病监测方案的要求,连续5年对河南省克山病病区开展病例搜索,选择有代表性的16个自然村进行了病情重点监测,每个监测点对调查对象进行详细询问病史、临床查体和心电图描记,对可疑心脏异常者拍摄后前位X线胸片,同时对病区儿童头发和粮食检测硒含量。结果共搜索心肌疾病病例315例,诊断慢型克山病28例。5年共重点监测居民6 102人,检出克山病患者40例(其中潜在型26例,慢型14例),检出率为0.66%。描记心电图6 102例,异常心电图检出率为25.8%(1 572/6 102)。拍摄193例X线胸片,126例增大。采集头发、粮食等样品120份,病区居民发硒含量接近硒适宜地区的水平,粮食硒含量仍处于较低水平。结论河南省克山病病情达到消除指标,但监测中仍有慢型、潜在型患者检出;人体硒营养水平明显升高,与病区居民生活水平的提高和膳食营养的改善有关。

Objectives To observe the condition and control of the incidence of Keshan disease（KSD）in Henan province and provide evidence for scientific control and study. Methods According to the＂National Surveillance Programme of Keshan Disease＂,KSD cases of the past five years were searched. 16 representative villages were selected for surveillance.At each surveillance point,detail medical history,clinical examination and ECG data were obtained from each survey objects;for suspicious heart abnormal cases,chest X-ray for the front and back were taken;selenium content of the hair of the children in hospital wards and foods were determined. Results 28 cases of chronic keshan disease were diagnosed from315 cases of cardiac disease. 6 102 residents were monitored in 5 years;40 patients were diagnosed with Keshan disease（potential type 26 cases,chronic 14 cases）,with a detection rate of 0.66%. ECG result indicated 25.8% of 6102 residents had abnormal electrocardiogram. 191 cases had taken chest x ray;138 cases had myocardium increase. 120 samples of hair and foods were collected for the determination of selenium content;the selenium content of hair was acceptable,and the selenium contents of foods were still lower. Conclusions Keshan disease in Henan province reached the elimination target,but the potential and chronic KSD cases could still be detected. The increase in selenium levels could be due to the improvement of living standards and the improvement of dietary nutrition.