169云南省洱源县食盐加硒在预防克山病中的作用

目的分析硒碘盐（下称“硒盐”）在预防克山病的作用。方珐2007-2009年中央补助地方专项资金克山病防治项目中食盐加硒预防克山病项目连续3年在洱源县实施，严格遵循国标（GB14880-94），在食用碘盐中加入亚硒酸钠（7～11mg／kg）制成硒盐，要求硒盐覆盖全县居民，定期对硒盐进行抽检，并定期对补硒人群头发中的硒含量进行测定。结果每年硒盐的覆盖率均超过95％；项目实施期间6次对硒盐质量进行了跟踪监测，硒盐合格率逐年上升，目前合格率为72．5％；通过补硒，病区居民内环境硒含量从补硒前的0．171mg／kg分别上升至2007年7月份的0．197mg／kg、2008年4月份的0．2895mg／kg、2008年10月份的0．3005mg／kg，2009年8月份的0．33mg／kg。提示人体内环境硒水平在随着补硒时间的延长逐渐上升；补硒期间项目县境内未发生急型、亚急型克山病新发病例。结论食盐加硒预防急型、亚急型克山病经济、方便，效果明显，应在全省重病区推广。但应随着补硒时间延长，逐渐降低加硒的比例，以防引起补硒人群体内硒的蓄积。

Data analysis of iodized salt with selenium to prevent Keshan disease in eryuan county of yunnan province

Objective To analyze the effect of selenium iodized salt for the prevention of Keshan disease. Methods During the consecutive years 2007 to 2009, Central subsidized project of salt with selenium supplement for the prevention of Keshan disease was implemented in Eryuan county. With strict reference to the national standard GB14880-94, iodized salt added with sodium selenite （7-11 mg/kg） was offered to the whole county. The quality of the salt was regularly sampled and the hair selenium content in the residents was regularly measured. Results The coverage of selenium salt was over 95% each year. During the three years, the quality of the selenium salt was tracked and monitored 6 times. Results showed the passing rate of selenium salt increased year by year, eventually reaching 72.5%. The hair selenium in the residents mounted from 0. 171 to 0. 197 in July 2007, to 0.289 5 in April 2008, to 0. 300 5 mg/kg in Oct. 2008, and to 0.33 mg/kg in Aug. 2009, indicating that the selenium content in human body gradually increased with time. No acute or subacute Keshan cases was found when the project was carried out. Oonclusion It＇s economical, convenient and effective to prevent acute and subacute Keshan disease with selenium iodized salt. However, with time extension, the selenium content in salt should be gradually reduced in order to avoid selenium accumulation in human body.