山东省克山病病情及发病相关因素5年动态观察

目的 观察克山病病情和发病相关因素动态变化，为科学的指导克山病防治研究提供依据。方法 在山东克山病重病区莒县安庄和邹城市张庄设立2个监测点，自2000年起对3～14岁的1049例多发人群和点区县克山病病情进行连续5年动态监测，观察人群全部进行临床检查、心电图检查，可疑病人行X线胸部摄片，并对监测居民内、外环境（发、小麦、玉米、地瓜干）硒水平、经济情况及人均占有粮食进行了调查。结果 5年间2县无急型、亚急型发病，原有慢型97例，死亡10例，新发病5例。多发人群克山病检出率2000、2002及2004年安庄点依次为3．31％、4．86％、4．45％，张庄点为3．69％、4．86％、4．45％。异常心电图检出率2000、2002及2004年安庄点依次为3．31％，7．16％，5．39％；张庄点为6．38％，4．55％，5．27％。发硒水平逐年升高，粮食硒含量基本恒定。经济收入和人均占有口粮逐年增加，达137．9％。260．0％。结论 5年间克山病多发人群和点区县病情无明显变化，发病相关因素不断改善。

Serial observation on condition and related factors of Keshan Disease in Shandong Province

Objective Observe the serial changes of condition and related factors of Keshan disease (KSD) in order to provide scientific basis for prevention and cure of KSD. Methods Two surveillance points of Keshan disease were set up in serious KSD area-Juxian Anzhuang and Zoucheng Zhangzhuang. Condition of KSD of 1 049 cases from 3 to 14 years old frequently occurring KSD were observed and the incidence of acute, subacute and chronic KSD were survived in two surveillance points from 2000 to 2004. All subjects were chalked up, electrocardiograms recorded and photograph of chests taken by X-ray. Selenium (Se) in internal and external environments (hair, wheat, corn, sweet, potato) were measured. Economic and grain condition were investigated.Results Five patients with chronic KSD appeared but acute and subacute KSD did not occur. Ten patients died among 97 patients with chronic KSD. The incidence rate of KSD on surveillance subjects in 2000, 2002, 2004 respectively were 3.31%, 4.86% and 4.45% at Anzhuang point and 3.69%, 4.86% and 4.45% at Zhangzhuang point. The incidence of abnormal electrocardiogram in 2000, 2002, 2004 respectively were 3.31%, 7.16% and 5.39% at Anzhuang point and 6.38%, 4.55% and 5.27% at Zhangzhuang point. Se contents of hair were increased constantly and Se contents of grain were raised too. Economic and grain condition were improved obviously and it was 137.9% to 260.0%.Conclusions Related factors of KSD were improved and condition of KSD was in steady situation in Shandong Province during 5 years.