承德市坝上地区大骨节病历史重病区的现状调查分析

Investigation and analysis of Kaschin-Beck disease in the historical critical diseased areas of Chengde Bashang area

目的为摸清80年代大骨节病重病区的承德坝上地区当前发病情况及其环境中硒含量的变化水平。方法通过与1982-1984年历史资料比对,2018年在承德市坝上地区围场县、丰宁县2个大骨节病历史重病区,分别选择1个病区村和1个非病区村开展相关基础数据调查与监测,包括儿童大骨节病X光片检查、儿童发样采集、土壤样品采集、粮食样品采集,并依据国家相关标准测定样品中硒元素含量,与历史资料进行比对分析。结果2018年历史重病区儿童大骨节病的检出率为0;丰宁县病区村和非病区村的儿童发硒含量分别为(0.208±0.063)mg/kg、(0.260±0.082)mg/kg,围场县为(0.299±0.067)mg/kg、(0.263±0.058)mg/kg;丰宁县病区村和非病区村的土壤硒含量分别为(0.251±0.096)mg/kg、(0.259±0.033)mg/kg,围场县为(0.080±0.019)mg/kg、(0.147±0.029)mg/kg;丰宁县自产粮莜麦的硒含量为(0.041±0.010)mg/kg、围场县自产粮玉米的硒含量为(0.031±0.010)mg/kg、两个县外购粮食面粉的硒含量为(0.047±0.013)mg/kg。结论土壤、粮食、儿童头发硒含量的提高是影响大骨节病病情下降的决定性因素,,承德坝上地区通过在大骨节病区实施换粮、退耕还林还草等方式调整产业结构,改善当地居民的营养水平,居民的抗病能力增强,从而使当地的患病率逐渐降低。目前,承德市历史重病区的大骨节病已全部消除。

Objective In order to find out the incidence of Kaschin-Beck disease and the change level of selenium content in the environment in Bashang area of Chengde,where was the Kaschin-Beck’s disease serious territory in the 1980 s.Methods Selecting an endemic village and a non-endemic village in Weichang and Fengning County respectively,to carry out basic data investigation and monitoring in 2018,which included childrens’X-ray examination and determination the selenium content of of hair,soil and grain samples.The final data were compared with historical data from 1982 to 1984.Results The detection rate of Kaschin-Beck disease in children in 2018 was 0;The selenium content in children’s hair of the endemic and non endemic villages in Fengning County was(0.208±0.063)mg/kg and(0.260±0.082)mg/kg,respectively,which was(0.299±0.067)mg/kg and(0.263±0.058)mg/kg in Weichang County.The soil selenium content of the endemic and non endemic villages in Fengning County was(0.251±0.096)mg/kg and(0.259±0.033)mg/kg,respectively,which was(0.080±0.019)mg/kg and(0.147±0.029)mg/kg in Weichang County;The selenium content of naked oats in Fengning County was(0.041±0.010)mg/kg,that of corn in Weichang County was(0.031±0.010)mg/kg,and that of purchased grain flour in two counties was(0.047±0.013)mg/kg.Conclusions Improvement of selenium content in soil,grain and children’s hair is an important factor for the decline of Kaschin-beck disease.Through implementation of Grain Exchange and returning farmland to forest and grass in Kaschin-Beck disease area,the industrial structure was adjusted,those improved the nutritional level and enhanced the disease resistance of residents,so as to reduce the local prevalence.At present,Kaschin-Beck disease has been completely eliminated in historical seriously ill area of Chengde.