陕西省黄陵县克山病8年监测结果分析

目的 观察陕西省黄陵县1995～2002年克山病病情变化。方法 在黄陵县的6个重病村设立监测点，全体居民均为监测对象，同时对全县慢型克山病（慢克）的发病情况进行监测，并对监测点3～15岁儿童内环境硒水平进行监测。结果 （1）6个监测点8年共检出慢克病人20例，潜在型克山病病人（潜克）282例，新发潜克病人14例。1995、1997、1999、2000和2002年克山病的检出率分别为4．3％、3．6％、7．5％、8，0％和8．5％；患病率为1．0％、2．4％、3．2％、3．6％和2．0％；潜在型克山病的新发生率为55．6／万、53．5／万、19．5／万、o／万和25／万；（2）8年全县共确诊慢克病人62例，死亡22例，15例死于慢性充血性心力衰竭，7例死于猝死；（3）监测点3～15岁儿童发硒与非病区儿童比较，差异无显著意义。结论 陕西省黄陵县监测点克山病的检出率呈缓慢上升态势，发病率呈平稳态势，但潜在型克山病仍有新发。

Eight years follow-up study of Keshan disease in Huangling county, Shaanxi province

Objective To observe the dynamic changes for the state and related factors of Keshan disease.Methods Surveillance point of Keshan disease condition was set up in6villages where the disease occurs seriously in Huangling county and all local residents were treated as surveillance subjects.State and change of Keshan disease in the surveillance point were observed successively for8years from1995to2002and at the same time selenium(Se)levels in hair samples of children in age from3to15years were measured.Results(1)Total of20chronic,282potential and14new cases were diagnosed during the past8years in the6monitoring sites.The incidence of latent and chromic Keshan disease in1995,1997,1999,2000and2002was4.3%,3.6%,7.5%,8.0%,and8.5%,respectively,the morbidity rate was1.0%,2.2%,3.2%,3.6%and2.0%,respectively,The morbidity of latent Keshan disease were55.6/ten thousand,53.5/ten thousand,19.5/ten thousand,0/ten thousand and25/ten thousand,respectively.(2)All over the county,total of62cases were diagnosed as chronic Keshan disease in the county in8years,22cases died,in which,15cases died form chronic congestive heart failure,7died at sudden death.(3)The hair selenium contents of cases from children in age of3to15year in the area of Keshan disease were not significantly different from those in the non-endemic area.Conclusions The rate of diagnosed Keshan disease is going up slowly,the incidence of Keshan disease is steady,but still has new cases of latent Keshan diseases in Huangling county,Shaanxi province.