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目的了解甘肃省克山病的流行病学特点,为调整防治对策及病因研究提供科学依据。方法 1990～2007年选择甘肃省克山病历史重病区西和县杨庄村与泾川县向明村为克山病病情监测点。收集监测村的生态数据;对监测点的所有常住居民进行体检、心电图检查和对疑似患者拍摄2m后前位X线胸片,同期采集3～14岁儿童、18～45岁育龄期妇女和克山病患者3个人群发样各10份。发硒检测采用2、3-乙氨基萘荧光法。结果杨庄监测点潜在型克山病年均发病率为3.84%(2.82%～7.71%),同期的向明监测点1990～1995年潜在型克山病发病率在0.6%～1.52%之间,人群居住条件改变后的1997～2007年潜在型克山病发病率在0%～0.14%之间,且2个监测点年均潜在型发病率(χ~2=194.066,P=0.000)有显著性差异,克山病人群心电图异常指标分布不同并有显著性差异(χ~2=37.352,P=0.000)。2个监测点3～14岁儿童、18～45岁育龄期妇女和患者人群的硒营养水平基本呈逐年缓慢上升趋势,但杨庄村随着人群硒营养水平逐年缓慢下降而潜在型克山病发病率呈逐年上升的趋势,相反,在向明村随着人群硒营养水平逐年缓慢上升而潜在型克山病发病率呈逐年下降的趋势。结论不同生态类型病区克山病的流行态势不同,在克山病病区呈阶梯状分布的居住形式是克山病发生的生态条件。
Objective To understand the epidemiological characteristics of Keshan disease in Gansu Province and provide a scientific basis for the adjustment of control strategies and etiology. Methods From 1990 to 2007, Kakeama Disease was selected as the monitoring point for Keshan Disease in Yangzhuang Village and Xiangchuan Village, Xihe County, Gansu Province. Collecting the ecological data of the monitoring villages; carrying out physical examination, electrocardiogram examination and the anterior chest X-ray of 2m after the suspected patients were taken for all the permanent residents in the monitoring sites; the women of 3-14 years old, the women of childbearing age 18-45 years and the g Mountain sickness 3 crowd hair samples each 10 copies. Hair selenium detection using 2,3 - ethynaphthalene fluorescence method. Results The average incidence rate of potential Keshan disease in Yangzhuang monitoring site was 3.84% (2.82% -7.71%). The incidence of latent Keshan disease in the Xiangming detection site during 1990 to 1995 was between 0.6% and 1.52% The incidence of latent Keshan disease was between 0% and 0.14% between 1997 and 2007 after the population living conditions were changed. The average annual incidence of potential disease (χ ~ 2 = 194.066, P = 0.000) in two monitoring sites was Significant differences, Keshan patients ECG abnormal distribution of indicators and have significant differences (χ ~ 2 = 37.352, P = 0.000). The selenium nutrition level in 2 monitoring sites for children aged 3-14 years and women of childbearing age ranged from 18 to 45 years increased slowly year by year. However, as the selenium nutrition level of population in Yangzhuang village decreased slowly year by year, latent Keshan disease The rate showed a trend of rising year by year. On the contrary, the incidence of latent Keshan disease showed a decreasing trend year by year as the level of selenium nutrition in the Xiangmiancun gradually increased year by year. Conclusion The prevalence of Keshan disease in different types of ward is different, and the living form in Keshan disease is a ecological condition of Keshan disease.