2018年四川省阿坝州大骨节病历史重病区内、外环境病情影响因素分析

目的了解四川省阿坝州大骨节病历史重病区内、外环境硒及T-2毒素水平。方法2018年7月至2019年2月,在阿坝州马尔康市、壤塘县、阿坝县、若尔盖县、红原县5个大骨节病历史重病区市(县),分别选择1个历史重病区乡,每个乡选择1个历史重病区村和1个非病区村。每个村采集30名常住6~12周岁儿童发样,检测发硒含量;每个村采集10户家庭主食粮样,检测粮食硒含量及T-2毒素含量;每个村采集10份土壤样,检测土壤硒含量。结果病区村和非病区村儿童发硒(n=180、120)中位数分别为0.2600、0.3300 mg/kg,病区村低于非病区村(Z=-6.319,P<0.01);其中马尔康市和红原县病区村儿童发硒均低于非病区村(Z=-3.327、-4.939,P均<0.01),壤塘县和若尔盖县病区村与非病区村间比较差异均无统计学意义(P均>0.05)。病区村和非病区村粮食硒(n=110、70)中位数分别为0.0058、0.0180 mg/kg,病区村低于非病区村(Z=-2.263,P<0.05);其中若尔盖县病区村粮食硒低于非病区村(Z=-2.306,P<0.05),马尔康市、壤塘县、红原县病区村与非病区村间比较差异均无统计学意义(P均>0.05)。病区村和非病区村粮食(n=103、65)T-2毒素含量均低于检出限(1μg/kg)。病区村和非病区村土壤(n=60、40)硒含量分别为(0.0453±0.0215)、(0.0658±0.0454)mg/kg,病区村低于非病区村(t=2.672,P<0.05);其中红原县病区村土壤硒低于非病区村(t=14.838,P<0.01),马尔康市、壤塘县、若尔盖县病区村与非病区村间比较差异均无统计学意义(P均>0.05)。结论四川省阿坝州大骨节病历史重病区儿童发硒整体处于中等水平(0.25~<0.50 mg/kg),粮食、土壤硒整体处于缺乏水平(<0.025、<0.125 mg/kg),且病区村均低于非病区村;粮食中未检出T-2毒素。

Analysis of influencing factors in internal and external environment in the historical critical disease area of Kashin-Beck disease in Aba State of Sichuan Province in 2018

Objective To understand the levels of selenium and T-2 toxin in the historical critical disease area of Kashin-Beck disease in Aba State of Sichuan Province.Methods From July 2018 to February 2019,in five cities(counties)of historical critical Kashin-Beck disease areas,namely,Ma'erkang,Rangtang,Aba,Ruo'ergai and Hongyuan,one township was selected,respectively,and then one village in the historical critical disease area and one village in non-disease area were selected from the selected townships.Hair samples from 30 children aged 6 to 12 years old were collected to test selenium content in each village.Staple food samples of 10 households were collected to test the selenium and T-2 toxin contents in each village.Ten soil samples were collected from each village to test the selenium content.Results The medians selenium of children's hair in the diseased and non-diseased villages(n=180,120)were 0.2600 and 0.3300 mg/kg,respectively,and the diseased village was lower than non-diseased village(Z=-6.319,P<0.01).In Ma'erkang and Hongyuan,the medians selenium in the diseased villages were lower than those in non-diseased villages(Z=-3.327,-4.939,P<0.01),and there were no statistically significant differences between the diseased villages and non-diseased villages in Rangtang and Ruo'ergai(P>0.05).The medians selenium of staple food in the diseased and non-diseased villages(n=110,70)were 0.0058 and 0.0180 mg/kg,respectively,and the diseased village was lower than non-diseased village(Z=-2.263,P<0.05).In Ruo'ergai,the median selenium in the diseased village was lower than that in non-diseased village(Z=-2.306,P<0.05),and there were no statistically significant differences between the diseased villages and non-diseased villages in Ma'erkang,Rangtang and Hongyuan(P>0.05).The T-2 toxin contents in staple food were all less than detection limit(1μg/kg)in the diseased and non-diseased villages(n=103,65).The soil selenium contents in the diseased and non-diseased villages(n=60,40)were(0.0453±0.0215)and(0.0658±0.0454)mg/kg,respectively,and the diseased village was lower than non-diseased village(t=2.672,P<0.05).The soil selenium content in the diseased village was lower than that in non-diseased village in Hongyuan(t=14.838,P<0.01).There were no statistically significant differences in the soil selenium content between the diseased villages and non-diseased villages in Ma'erkang,Rangtang and Ruo'ergai(P>0.05).Conclusions The overall selenium level of children's hair is at a medium level(0.25-<0.50 mg/kg)in the historical critical disease area of Aba State of Sichuan Province,the selenium levels of staple food and soil are at a deficiency level(<0.025,<0.125 mg/kg),and the diseased villages are lower than non-diseased villages.No T-2 toxin is detected in staple food.