2008年山东省15县(市、区)克山病病情与内外环境硒水平调查

目的对山东省克山病病区居民进行病情与硒营养状况调查。方法 2008年选择山东的五莲、莒县、沂水、蒙阴、平邑、莒南、青州、临朐、安丘、泗水、邹城、滕州、山亭、沂源、新泰15个病区县(市、区),每个县设立1个调查点,每个点调查700人左右,对调查对象进行一般体格检查、描记心电图、后前位X线胸部摄片,同时采集病区居民的头发及小麦、玉米、地瓜干,采用2,3-二氨基萘荧光法测定硒含量。结果山东省15个县(市、区)共调查10679人,检出克山病患者315例,总检出率2.95%,总标化率2.97%,其中潜在型克山病287例,检出率2.69%,标化率2.72%;慢型克山病28例,检出率0.26%,标化率0.24%,未检出急型、亚急型患者。检出异常心电图1776例,检出率16.6%;共摄片461例,心脏增大195例,异常检出率42.3%。采集发、小麦、玉米及瓜干依次为263、270、298和258份;其硒含量依次为(0.5191±0.5538)、(0.0268±0.0045)、(0.0194±0.0052)和(0.0193±0.0039)mg/kg。结论目前山东省克山病的发病处于稳定态势,病区居民发硒达到硒适宜地区水平,内环境硒营养状况改善,克山病的患病率有望进一步降低。

Surveys on the conditions of Keshan disease and selenium levels of 15 counties in Shandong Province in 2008

Objective To investigate the conditions of Keshan disease and the selenium nutritional status of residents in Keshan disease endemic area in Shandong Province.Methods One site from each of 15 Keshan disease endemic counties in Shandong Province was selected for the survey and 700 subjects in each site were randomly selected for the investigation.Physical examination,electrocardiogram and X-ray radiography of the subjects and the selenium contents of hair,wheat,corn and dried sweet potato were surveyed.Results A total of 10679 people were investigated in 15 counties and 315 patients were found,including 287 cases of latent type and 28 cases of chronic type,but no acute or subacute type patients were found.There were 1776 cases of abnormal electrocardiogram.Among the 461 cases checked up by radiography,the heart of 195 cases was enlarged.The selenium content of hair, wheat,corn and dried sweet potato were ( 0.5191 ± 0.5538 ),( 0.0268 ± 0.0045 ),( 0.0194 ± 0.0052 ) and (0.0193 ± 0.0039) mg/kg respectively.Conclusion The occurrence of Keshan disease is in a stable status in Shandong Province at present.Hair selenium of residents in Keshan disease endemic area has reached an appropriate level.The selenium nutritional status of residents has improved,and the prevalence of Keshan disease is expected to be decreased in these areas.