| 2018年河北省张家口市克山病病区人群内外环境硒水平调查分析 |
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| 引用本文： | 谷海军,郝丽萍,李丽,张海霞,韩国义. 2018年河北省张家口市克山病病区人群内外环境硒水平调查分析[J]. 疾病监测, 2022, 37(4): 517-522. DOI: 10.3784/jbjc.202106080323 |
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| 作者姓名： | 谷海军 郝丽萍 李丽 张海霞 韩国义 |
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| 作者单位： | 1.张家口市地方病防治所, 河北 张家口 075000 |
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| 基金项目： | 河北省医学科学研究计划（No. 20201596） |
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| 摘 要： | 目的 了解2018年河北省张家口市克山病病区与非病区人群内、外环境硒水平，为确定防治重点和制定可持续消除克山病防治措施提供依据。 方法 根据《全国克山病病区与非病区人群内、外环境硒水平及相关因素调查方案》， 于2018年9月开展张家口市克山病病区与非病区人群硒调查。 在张家口市选择克山病病情控制达标历史病区（县）3个，消除达标病区（县）4个，以及2个非病区（县）作为调查县，每县选择1个乡，每乡选择1个村作为调查点，每个村选择10户家庭（其中生活条件好、中、差各3、4、3户）作为调查对象，共采集儿童、育龄期妇女和成年男性发样270份以及主食粮样品3种270份，同时采集调查点土壤样品90份，采用氢化物原子荧光光谱法测定硒含量，并采用EpiData 3.5.1、 SPSS 22.0软件对测定结果进行t检验和方差分析。 结果 克山病病区土壤硒含量高于非病区，差异无统计学意义（P＞0.05）。 全市9个区（县）人群平均发硒含量为（0.350 7±0.101 4） mg/kg，总体调查显示硒营养水平处于中等水平。 病区儿童发硒含量低于非病区，差异无统计学意义（P＞0.05），病区成年人发硒含量与非病区比较差异无统计学意义。 病区粮食硒含量低于非病区，差异无统计学意义（P＞0.05）。 不同生活条件病区居民食用粮（面粉、大米、黍子面）硒含量测定结果比较差异无统计学意义。 结论 张家口市克山病病区外环境硒水平基本恒定，而内环境发硒含量却显著升高，可能与生活水平的提高和膳食结构的改变有关，应持续监测以巩固克山病消除成果。
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| 关 键 词： | 克山病 内外环境 硒营养水平 |
| 收稿时间： | 2021-06-08 |
Investigation of selenium levels in internal and external environments in population in Keshan disease endemic area in Zhangjiakou,Hebei, 2018 |
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| Affiliation: | 1.Zhangjiakou Institute of Endemic Disease Prevention and Control, Zhangjiakou 075000, Hebei, China2.Zhangjiakou Medical Insurance Bureau, Zhangjiakou 075000, Hebei, China3.Institute of bacterial disease control and disinfection, Hebei Center for Disease Control and Prevention, Shijiazhuang 050021,Hebei, China |
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| Abstract: | Objective To understand the selenium levels in the internal and external environments in endemic and non-endemic areas of Keshan disease in Zhangjiakou, Hebei province, and provide the basis for the identification of the prevention and control priorities and development of sustainable prevention and control measures to eliminate Keshan disease. Methods According to the National Survey Program on Selenium Levels and Related Factors in Internal and External Environments in endemic and non-endemic areas of Keshan Disease, the Keshan Disease Selenium Survey was carried out in September 2018 in 3 counties (district) where Keshan disease has been controlled and 4 counties (district) where Keshan disease has been eliminated and 2 counties (district) without Keshan disease in Zhangjiakou. Ten families, including 3, 4 and 3 families with poor, moderate and good living conditions, in one village of one township of these areas were surveyed. A total of 270 hair samples were collected from children, childbearing aged women and adult males and a total of 270 samples of 3 kinds of staple foods were collected. Meanwhile, a total of 90 soil samples were collected from the survey sites. The selenium content was detected by hydride atomic fluorescence spectrometry, and the t-test and variance analysis were performed by using software EpiData 3.5.1 and SPSS 22.0. Results The soil selenium content in Keshan disease endemic area was higher than that in non-endemic area, but the difference was not significant (P＞0.05). The average hair selenium content in residents in 9 counties of Zhangjiakou was (0.3507±0.1014) mg/kg, and the overall nutrient level of selenium was moderate. The selenium content in children in the disease endemic area was lower than that in those in non-disease endemic area, and there was no significant difference (P＞0.05), and the difference in hair selenium content between the adults in the disease endemic area and those in the non-disease endemic area had no significance. The food selenium content in the disease endemic area was lower than that in the non-disease endemic area, and there was no significant difference (P＞0.05). The differences in food selenium content among the different stable foods, including wheat flour, rice and broomcorn millet flour, in the families with different living conditions were not significant. Conclusion The selenium level in the external environment in Keshan disease endemic area in Zhangjiakou were basically stable, while the selenium content in the internal environment in the Keshan disease endemic area significantly increased, which might be related to the improvement of living standard and the change of dietary structure, so continuous surveillance should be carried out to consolidate the achievement in the elimination of Keshan disease. |
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