陕西省黄陵县克山病病情15年连续观察

目的观察陕西省黄陵县1990-2004年克山病病情及相关因素的变化。方法对黄陵县的克山病重病村设立监测点,全体居民均为监测对象,对全县范围内的慢型克山病(慢克)进行监测,并对监测人群的发硒、粮硒水平进行监测。结果(1)监测点区15年共检出潜在型克山病(潜克)447例,检出率6．14％;新发潜克33例,年均新发生率34．34／万;(2)15年黄陵县慢克确诊72例,先后死亡31例,死亡率43．1％,其中20例死于慢性充血性心力衰竭,11例死于猝死;(3)监测人群发硒与非病区比较差异无统计学意义,粮硒仍低于非病区。结论陕西省黄陵县监测点区克山病的检出呈缓慢上升趋势,潜克仍有新发,慢克死亡率仍很高。

Consecutive 15-years observation on Keshan Disease in Huangling County of Shaaxi Province

Objective To observe changes of prevalence and the related factors of Keshan disease. Methods Some villages where the disease occurred seriously were set up as surveillance sites in Huangling county and all the local residents were monitored for the past 15 years from 1990 to 2004. Chronic Keshan disease was surveyed in all over the county. At the same time, selenium levels were measured in hair and cereal samples from local residents. Results (1) 447 cases were diagnosed as latent Keshan disease in the surveillance area. The diagnosed rate was 6.14%. 33 new cases of latent Keshan disease were diagnosed. The new incidence of latent Keshan disease was 34.34/ten thousand every year.(2) In this county, altogether 72 cases of chronic disease were found in the past 15 years, among whom 31 died. Mortality was 43.1% ,in which, 20 cases died from chronic congestive heart failure, 11 cases died from sudden death. (3) The hair selenium contents in the area of Keshan disease were not significantly different from those in non-endemic area. Conclusions The prevalence of the disease is slowly going up. New cases of latent Keshan disease keep occurring in this area. Mortality of chronic Keshan disease is still very high.