阿坝州大骨节病综合防治试点工作效果观察

The Effects of Pilot Integrated Control of Kaschin-Beck Disease in A'ba Prefecture

目的了解阿坝州大骨节病患者病情变化和发展趋势,探索相关危险因素。方法根据《阿坝州扶贫开发和综合防治大骨节病试点工作总体规划》的要求,按照病情轻、中、重程度,每年设立大骨节病监测点,开展儿童大骨节病病情和相关危险因素监测。结果 2007-2015年共临床检查7~12岁儿童45 249人,查出Ⅰ度及Ⅰ度以上儿童大骨节病患者18人,临床平均检出率为0.04%,共拍摄7~12岁儿童X线片39 384张,X线阳性片247张,X线阳性检出率为0.27%(247/39 384),干骺端阳性检出率从2007年的2.18%下降到2015年的0.11%,检出率下降了2.07%(χ~2=69.53,P<0.01);骨端阳性检出率从2008年的1.73%持续下降到2015年的0.00%,检出率下降了1.35%(χ~2=58.59,P<0.01)。结论阿坝州儿童大骨节病病情呈逐年下降的趋势,病情稳定,大骨节病新发得到遏制,综合防治措施取得明显成效,红原、茂县和松潘等各别县不能放松警惕,继续加强监测。

Objective To investigate changes and progression of disease conditions of patients with kaschin-beck disease in A＇Ba Prefecture and explore relevant risk factors. Methods Following the requirements in the General Plan for Pilot Integrated Control of kaschin-beck disease and Poverty Eradication in A＇Ba Prefecture,surveillance sites were set on a yearly basis by severity of disease conditions（ mild,moderate and severe） and disease conditions of pediatric patients and relevant risk factors were monitored. Results From 2007 to 2015,45 249 chidlren aged between 7 and 12 years were examined. Eighteen children with grade I or severer kaschin-beck disease were found,and the averge clinical detection rate was 0. 04%. A total of 39 384 X-ray films were taken,and 247 positive X-ray films were found; the X-ray positive rate was 0. 27%（ 247/39 384）.The metaphysis detection rate declined by 2. 07% from 2. 18% in 2007 to 0. 11% in 2015（ χ^2= 69. 53,P〈0. 01）. The epiphysis detection rate declined by 1. 35% from 1. 73% in 2007 to 0. 00% in 2015（ χ^2= 58. 59,P〈0. 01）. Conclusion The condition of kaschin-beck disease in children improved year by year; new onset has been controlled; the integrated control measures have yielded notable effects. However,the condition is still serious in some counties including Hongyuan, Maoxian and Songpan, and surveillance should be enhanced.