2009年黑龙江省大骨节病历史病区成人颈动脉粥样硬化调查

目的 调察黑龙江省大骨节病历史病区成人大骨节病病例颈动脉粥样硬化的流行强度,探讨成人大骨节病与动脉粥样硬化发生的关系.方法 2009年,在黑龙江省大骨节病病区山河农场、尚志市和非病区双城县兰棱镇(简称双城对照区),各调查5个村,以40岁以上病区大骨节病患者和双城对照区居民为观察对象,用便携式彩超进行了颈动脉粥样硬化检查,保留超声图片并按病变程度诊断记分.结果山河病区5个村大骨节病病例颈动脉粥样硬化检出率分别为50.0%(26/52)、37.3%(19/51)、42.5%(30/71)、58.2%(39/67)、44.0%(22/50);尚志病区5个村分别为63.0%(34/54)、45.3%(24/53)、47.2%(25/53)、60.0%(30/50)、51.9%(28/54);双城对照区5个村分别为63.9%(46/72)、43.1%(31/72)、57.1%(40/70)、46.9%(30/64)、53.0%(35/66).以村为单位,山河、尚志病区与双城对照区颈动脉粥样硬化标准化检出率比较,差异均无统计学意义(T值分别为25.0、24.5,P均＞0.05);3个地区间颈动脉粥样硬化标准化检出率比较,差异无统计学意义(x2=0.36,P＞0.05);3个地区间颈动脉粥样硬化标准化严重程度比较,差异有统计学意义(x2=15.28,P＜0.05),其中尚志病区与双城对照区比较,差异有统计学意义(x2=8.92,P＜0.05).大骨节病患者病情严重程度与颈动脉粥样硬化的标准化检出率和严重程度间均未见明显关联(x2值分别为1.88、5.07,P均＞0.05).结论黑龙江省大骨节病历史病区成人颈动脉粥样硬化检出率不高于非病区.

Survey of adult carotid atherosclerosis in historical endemic area of Kaschin-Beck disease in Heilongjiang province in 2009

Objective To assess the prevalence of carotid atherosclerosis in adult patients with KaschinBeck disease(KBD) in endemic area, and to investigate the association between KBD and atherosclerosis. Methods B-mode ultrasound was used to investigate carotid atherosclerosis in patients with KBD over 40 years old in Shanhe farm and Shangzhi city and residents in Shuangcheng county in 2009. Ultrasonography images were saved and graded according to intima media morphology. Results The prevalence rates of carotid atherosclerosis in patients with KBD from the 5 villages affiliated to Shanhe farm were 50.0%(26/52),37.3%( 19/51 ),42.5%(30/71 ),58.2% (39/67) and 44.0% (22/50) , respectively. The prevalence rates of carotid atherosclerosis in patients with KBD from the 5 villages affiliated to Shangzhi city were 63.0% (34/54), 45.3% (24/53), 47.2% (25/53), 60.0% (30/50)and 51.9% (28/54), respectively. The prevalence rates of carotid atherosclerosis in people without KBD in the 5 control villages affiliated to Shuangcheng county were 63.9% (46/72),43.1% (31/72),57.1% (40/70),46.9% (30/64) and 53.0%(35/66), respectively. Ten villages in KBD endemic area and 5 villages in control area were investigated. The prevalence rates of carotid atherosclerosis in the 15 villages were standardized and compared by Wilcoxon test. The differences were not significant between two KBD endemic areas and one control( T = 25.0,24.5,all P ＞ 0.05). There was no significant difference in prevalence of atherosclerosis in the 3 areas(x2 = 0.36, P＞0.05). Comparing the severity of carotid atherosclerosis in 3 locations, the difference was statistically significant (x2 = 15.28, P ＜ 0.05) and there was significant difference statistically between the subjects in Shangzhi city and that in the control group(x2 = 8.92, P ＜ 0.05). There was no significant difference between the detection rate of atherosclerosis and the severity of KBD, and similar results in the grade of atherosclerosis and the severity of KBD were found (x2 = 1.88,5.07, all P ＞ 0.05). Conclusions The prevalence rate of carotid atherosclerosis in historical endemic area in Heilongjiang province is not higher than that in the control area.