2009年云南省克山病病情监测结果分析

目的 掌握云南省克山病病情,为防治克山病提供科学依据.方法 云南省在克山病病情较重的12个县(市)实施克山病病情监测.每个项目县选择1个病区乡,每个病区乡选择1个病区村进行病情监测.监测点的所有居民都为监测对象.对全部监测对象进行临床检查和描记心电图,疑似克山病患者须拍摄2m后前位X线胸片.按<克山病诊断标准>(GB1...

Result analysis of Keshan disease surveillance in Yunnan Province in 2009

Objective To investigate the current situation of Keshan to provide scientific basis for the control and prevention of KD. Methods disease （KD） in Yunnan Province, and Current situation of KD was surveilled in 12 counties with serious KD condition. One town in each of the 12 counties was selected, and one village in each selected town was chosen as the investigation site. All residents in the villages were investigated, receiving clinical and electrocardiographic （ECG） examination. Suspected KD victims underwent 2-meter chest X-ray examination. Reference was taken from the diagnostic standard of KD （GB17021-1997） to confirm KD cases. Meantime, hair selenium content of 10 boys ≤ 12 years and 10 adult men was detected in each investigation site. Results 7495 residents were investigated in 2009 and 43 cases of KD were confirmed, with a total incidence rate of 0.57%. Of the 43 KD cases, 24 had latent KD （0.32%）, and 19 chronic KD （0.25%）. No acute or subacute cases were found. There were more female cases （27） than male cases （16）. The age of latent cases ranged 3-15 （9/24） and 15-24 （7/ 24） years, the age of chronic cases 55-64 （7/19） and 45-54 （5/19） years. Of the 7495 residents receiving ECG examination, 464 showed abnormal ECG （6.19%）, which showed primarily premature ventricular beat, complete right bundle branch block, left anterior hemi block, ST-T alter, and left ventricular hypertrophy. 66 X-ray films showed the cardiothoracic ratio was ≤0. 50 in 40 cases, 0. 51-0.55 in 16 cases, 0. 56-0.60 in 6 cases, and ≥0.61 in 4 cases. The average hair selenium was （0.24 ± 0.08） mg/kg, the lowest （0.15 ±0.03） mg/kg, found in Dayao County, and the highest （0.24±0.08） mg/kg, found in Eryuan County. Conclusion The detected ratio of KD is low and displays a downward trend of incidence in Yunnan province. The latent cases are mainly teenagers, and the chronic cases middle and old aged. Although hair selenium content in the 12 surveillance counties has reached the level in the non-disease areas, the significant difference still demands more attention.