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目的了解山西省克山病病情,为防治工作提供科学依据。方法在历史重病区永和、石楼每县选择1个病区乡,吉县选择2个病区乡,每乡选择1个病区村;每村选择600人左右,开展临床查体和心电图描记,同时采集部分居民发样和主食粮样检测内外环境硒含量水平。结果共检查3 285人,检出克山病病人142例,总检出率型4.32%。其中慢型克山病病人5例,检出率0.15%;潜在型克山病病人137例,检出率4.17%。检出异常心电图369例,异常率11.23%。克山病人心电图异常改变以完全性右束枝传导阻滞和ST-T改变为主,分别占到总异常项次的43.6%和24.8%。克山病病例男女性别比为1∶1.09。小麦、玉米、小米、豆面、头发样品硒含量水平分别为(0.020±0.006)、(0.014±0.009)、(0.017±0.012)、(0.051±0.024)和(0.051±0.024)mg/kg。结论本次调查山西省克山病检出率高于2007年全国平均水平,代表了山西省病情最严重的情况。但从总体上来说,全省病情基本稳定。研究结果再次证明,克山病病区内外环境处于低硒水平。克山病仍是严重的公共卫生问题之一,应该充分认识到防治监测工作的长期性、重要性和艰巨性。
Objective To understand the condition of Keshan disease in Shanxi Province and provide a scientific basis for prevention and treatment. Methods One ward area was selected in Yonghe and Shilou counties in the seriously ill-ward area. Two ward townships were selected in Ji County and one ward village in each township. About 600 people were selected in each village to carry out clinical examination and electrocardiogram At the same time, we collected some residents’ samples and staple food samples to test the levels of selenium in both domestic and foreign environments. Results A total of 3 285 people were examined, and 142 patients with Keshan disease were detected. The total detection rate was 4.32%. Among them, 5 cases were chronic Keshan disease, the detection rate was 0.15%; 137 cases were potential Keshan disease, the detection rate was 4.17%. 369 abnormal ECGs were detected, with an abnormal rate of 11.23%. Keshan patients with abnormal ECG changes in complete right bundle branch block and ST-T changes accounted for 43.6% and 24.8% of the total abnormal line. Keshan disease cases male to female ratio was 1: 1.09. The levels of selenium in wheat, corn, millet, bean face and hair samples were (0.020 ± 0.006), (0.014 ± 0.009), (0.017 ± 0.012), (0.051 ± 0.024) and (0.051 ± 0.024) mg / kg, respectively. Conclusion The detection rate of Keshan disease in Shanxi Province was higher than the national average in 2007, representing the most serious condition in Shanxi Province. However, on the whole, the province’s condition is basically stable. The results again proved that Keshan disease in and outside the environment at low selenium levels. Keshan disease is still one of the serious public health problems. The long-term importance and arduousness of prevention and control surveillance should be fully recognized.