2008年陕西省大骨节病病情调查分析

目的 掌握陕西省儿童及成人大骨节病病情现状,评估防治效果,为防治决策提供科学依据.方法 根据大骨节病历史资料,2008年在陕西省选择8个市10个病区县的10个重病村,对全部7～12岁儿童进行临床检查,拍摄右手X线片;选择10个市37个病区县的65个重病村,对≥16岁人群进行临床检查;在旬邑县的东、南、西、北4个方向各选择1个病区村补硒,在项目实施前、项目干预6个月,每个病区村检测30户家庭的硒碘盐含硒量,每村对30名7～12岁儿童检测发硒.结果 共对862名儿童进行临床检查,未检出Ⅰ度以上病例.X线检查862人,检出1例干骺端阳性病例,检出率为0.12%(1/862);65个病区村16岁以上成人共有35 638名,检查30 599人,受检率为85.86%(30 599/35 638).共检出大骨节病病例5108例,总检出率为16.69%(5108/30 599),其中I度检出率为9.73%(2977/30 599),Ⅱ度检出率为5.40%(1652/30 599),Ⅲ度检出率为1.57%(479/30 599),36～60岁患者占患者总数的65.7%(3355/5108).旬邑县在项目实施前、项目干预6个月,硒碘盐含硒量分别为(5.43±3.19)、(7.74±1.81)mg/kg,儿童头发含硒量分别为(0.3933±0.0930)、(0.3613±0.0997)mg/kg.结论 陕西省儿童大骨节病病情稳定下降,成人大骨节病病情严峻,应积极开展成人大骨节病治疗工作,并加大健康教育宣传力度,巩固防治成果.

Analysis and investigation on the Kaschin-Beck disease in Shanxi Province in 2008

Objective To master the status of Kaschin-Beck disease(KBD) in children and adults, assess the effect of prevention, and provide scientific basis for control strategies. Methods Based on history data, children aged 7-12 years in 10 heavy KBD villages of 10 counties of 8 cities were clinically examined and the X-Ray of right hand examination was conducted. Clinical examinations were carried out in the people over 16 years in 65 heavy KBD villages of 37 counties of 10 cities. One village was respectively selected in four directions of Xunyi countyto supply selenium(Se). The content of Se in hair of the 30 children aged 7 - 12 years was detected before and six months after the supplement of Se in each village. And the content of Se in selenium-iodine salt was detected in 30 families of each village. Results Among the 862 children, no cases beyond 1 degree were detected in the clinical examination. One out of 862 children had pathological changes in metaphysis and the detectable rate of X-Ray was 0.21%(1/862). Total 30 599 people in 65 villages were examined, aceounting for 88.56%(30 599/ 35 638). The total detectable rate of KBD was 16.69%(5108/30 599), and the detectable rate of Ⅰ degree, Ⅱ degree, Ⅲ degree was 9.73% (2977/30 599),5.4%(1652/30 599), 1.57% (479/30 599), respectively. The patients aged 36～60 years accounted for 65.7%(3355/5108) of the total patients. The eontent of Se was (5.43±3.19) mg/kg and (7.74±1.81)mg/kg respectively in the period before and 6 months after the supplement, and the content of Se in hair of children was (0.3933±0.0930)mg/kg and (0.3613±0.0997)mg/kg, respectively. Conclusions KBD in children is in a steady decrease in Shanxi, but the situation of KBD in adults is serious. The treatment for the adult KBD patients should be carried out actively, and health education should be strengthened to consolidate the achievements of prevention and control of the KBD.