2007年全国克山病病情监测汇总分析

目的 掌握2007年全国克山病患病及发病情况,为制订克山病防治策略提供科学依据.方法 根据2007年克山病监测方案及《克山病诊断标准》(GB 17021-1997),对15个病区省(区、市)的24个监测点居民进行查体、描记心电图、疑似病例摄X线胸片等临床检查.采集监测点居民主食粮样和发样,检测含硒量.结果 24个监测点居民潜在型、慢型克山病检出率分别为2.4%(465/19280)、0.6%(119/19 280).按检出率区间估计,全国病区有235万例(216万～254万例)克山病病人,其中慢型48万例(39万～57万例).本次监测新检出潜在型克山病85例,慢型克山病9例.15个省(区、市)的22个监测点心电图检查的异常率为14.3%(2554/17 801).14个省(区、市)22个监测点X线胸片检查有心胸比例增大者占38.8%(285/734).11个省(区、市)17个监测点共采集发样566份,发硒平均水平为0.3848 mg/kg;15个监测点采集小麦254份.平均硒水平为0.0428 mg/kg;采集玉米213份.平均硒水平为0.0250 mg/kg.结论 克山病仍然是严重的地方性公共卫生问题.要坚持做好克山病监测工作,改进抽样方法,增强监测的代表性;建议加大监测的投入.开展概率抽样,进行总体推断.以适应克山病新形势下的要求.

Analysis of the data of national Keshan disease surveillance in 2007

Objective To study prevalence and incidence of Keshan Disease (KD) in China in 2007, and provide scientific basis for control strategies on KD. Methods Based on the Scheme of KD Surveillance and the Standard of Diagnosis of KD(GB 17021-1997), the residents in 24 surveillance sites of 15 provinces were surveyed by physical examination, electrocardiogram(ECM) and X-ray. The hair and food potentially related to KD were sampled for determination of selenium levels. Besults The prevalence of latent and chronic KD in 24 surveillance sites was 2.4%(465/19280) and 0.6%(119/19 280), respectively, and the number of KD patients in China was estimated to be 2.16 to 2.54 millions. Of them, 390 to 570 thousands were chronic KD patients. There were 85 and 9 new latent and chronic KD patients, respectively. ECG showed abnormalities in 2554 of 17 801 people(14.3%) in 22 surveillance sites. In 22 surveillance sites, 285 of 734 people(38.8%) checked by X-ray showed enlargement changes. The average level of hair selenium of 566 people in 17 surveillance sites surveyed was 0.3848 mg/kg (mean), and the average selenium level of wheat(254) and corn(213) in 15 surveillance sites surveyed was 0.0428 mg/kg (mean) and 0.0250 mg/kg (mean) respectively. Conclusions KD is still one of the serious endemic public health issues. Keshan disease surveillance should go on, and changing the sampling method, improving the representation of KD surveillance is the foundation for grasping the prevalence of KD. So more financial assistance providing for KD surveillance, random sampling, statistical inference for KD patients, all those changes adapted will meet KD prevention nowadays.