2016和2017年内蒙古自治区扎兰屯市大骨节病监测结果分析

Analysis of monitoring results of Kashin-Beck disease in Zhalantun City of Inner Mongolia Autonomous Region in 2016 and 2017

目的掌握内蒙古自治区扎兰屯市大骨节病病情变化和考核验收情况,为制订大骨节病防治策略提供科学依据。方法2016、2017年,在扎兰屯市下辖的每个县抽取5个病区乡镇,每个乡镇抽取3个病区村,调查病区村内全部7~12岁居住6个月以上的常住儿童的大骨节病患病情况。按照《大骨节病诊断》(WS/T 207-2010)标准进行临床和X线诊断,比较2016和2017年扎兰屯市7~12岁儿童的大骨节病患病情况;并依据《重点地方病控制和消除评价办法》(国卫疾控发[2014]79号)对大骨节病病情及防治措施落实情况进行考核验收。结果2016-2017年共检查7~12岁儿童1697名,未检出临床大骨节病病例,X线阳性改变病例11例;其中,2016年检查儿童844名,X线阳性率为0.24%(2/844),干骺端阳性率为0.24%(2/844),未检出骨端阳性改变及三联征病例;2017年检查儿童853名,X线阳性率为1.06%(9/853),干骺端阳性率为1.06%(9/853),未检出骨端阳性改变及三联征病例。2017年7~12岁儿童大骨节病X线阳性率、干骺端阳性率均高于2016年(χ^(2)=4.409、4.409,P均<0.05)。所有调查病区村均达到国家消除标准(7~12岁儿童无临床病例,X线阳性率≤3%且无手部骨端改变病例);2016、2017年扎兰屯市大骨节病防治工作组织管理评分均为88分,达到合格标准(>85分)。结论扎兰屯市大骨节病病情达到病区消除标准,为呼伦贝尔市进一步实现大骨节病全面消除奠定了基础。

Objective To master the changes of Kashin-Beck disease and the examination and acceptance in Zhalantun City,and to provide scientific basis for formulating prevention and control strategies of Kashin-Beck disease.Methods From 2016 to 2017,in each county under the jurisdiction of Zhalantun City,5 townships affected by the disease were selected,3 villages were selected from each township,and the prevalence of Kashin-Beck disease of all residential children aged 7 to 12 years who lived in the villages for more than 6 months were investigated.The clinical and X-ray diagnosis were performed according to the"Diagnosis of Kashin-Beck Disease"(WS/T 207-2010)standard,and the prevalence of Kashin-Beck disease in children aged 7 to 12 years in Zhalantun City in 2016 and 2017 were compared.In accordance with the"Key Endemic Disease Control and Elimination Evaluation Measures"([2014]79),the condition of Kashin-Beck disease and the implementation of its prevention and control measures was assessed.Results From 2016 to 2017,1697 children aged 7 to 12 years were examined,there were no clinical cases of Kashin-Beck disease and 11 cases of X-ray positive changes.Among them,844 children were examined in 2016,the positive rate of X-ray was 0.24%(2/844),the positive rate of metaphyseal was 0.24%(2/844),and no positive changes of extremities and triad were detected.A total of 853 children were examined in 2017,the positive rate of X-ray was 1.06%(9/853),the positive rate of metaphyseal was 1.06%(9/853),and no positive changes of extremities and triad were detected.The positive rate of X-ray and metaphyseal of Kashin-Beck disease in children aged 7-12 years in 2017 were higher than those in 2016(χ^(2)=4.409,4.409,P<0.05).All surveyed villages had reached the national elimination standard(no clinical cases for children aged 7-12 years,X-ray positive rate≤3% and no cases of hand bone end changes);the organization management scores of Kashin-Beck disease prevention and treatment in Zhalantun City in 2016 and 2017 were 88 points,reaching the qualified standard(>85 points).Conclusion The condition of Kashin-Beck disease in Zhalantun City has reached the standard of elimination,which lays a foundation for further comprehensive elimination of Kaschin-Beck disease in Hulunbuir City.