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目的为准确掌握克山病发病消长趋势,科学指导和评价克山病防治工作。方法按《全国克山病病情监测方案》要求,每年在克山病病区设立监测点,对监测人群进行临床检查、心电图描记、可疑心脏异常者进行后前位胸部Χ线拍片、心脏超声心动图检查,部分年份进行了内外环境硒含量、克山病发病相关因素监测。结果 7年来,累计调查克山病区居民31 463例,共检出克山病患者1 123例(其中潜在型克山病822例,检出率为2.61%,慢型克山病301例,检出率为0.96%),总检出率为3.57%。异常心电图检出率为10.67%,其中以ST-T改变、束支传导阻滞、多发多源性室早为多见。克山病发病相关因素监测表明,新发克山病户小麦、豆类、豆制品低于非病户的情况日趋改善,现已基本接近非病户水平。已接近国家营养供给量标准。结论克山病病情总体处于平稳低发态势。但致病因子仍在某些家庭起作用,新的潜、慢型克山病以缓慢、渐近、逐渐累积的形式仍有发生,其发病受生活水平波动及膳食结构诸因素影响较大。
Objective To accurately grasp the trend of the rise and decline of Keshan disease, scientific guidance and evaluation of Keshan disease prevention and control. Methods According to the requirements of “National Keshan Disease Surveillance Program”, monitoring points were set up every year in Keshan disease ward, and clinical examination, electrocardiogram and suspicious cardiac abnormalities were performed in front of post-chest chest X-ray film, echocardiography Figure examination, part of the selenium content of internal and external environment, Keshan disease-related factors monitoring. Results In the past 7 years, a total of 31 463 residents of Keshan Ward were investigated. Among them, 1 123 cases of Keshan disease were detected (including 822 cases of potential Keshan disease, the detection rate was 2.61%, 301 cases of chronic Keshan disease, Detection rate was 0.96%), the total detection rate was 3.57%. The detection rate of abnormal ECG was 10.67%, of which ST-T changes, bundle branch block, multiple multi-source room as early as more common. Monitoring of Keshan disease-related factors shows that the situation of patients with newly-developed Keshan disease is getting progressively lower than that of non-disease-free households and has basically approached the level of non-sick-patients. Already close to the national nutrient supply standards. Conclusion The overall condition of Keshan disease is in a stable and low tendency. However, the pathogenic factors still play a role in some families. The new latent and chronic Keshan disease still occur in a slowly, asymptotically and gradually cumulative form. The incidence is greatly affected by fluctuations in living standards and dietary factors.