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目的掌握莒县克山病病情现状和变化趋势,为科学地指导防治工作和评估防控效果提供依据。方法按照《山东省克山病监测实施方案》要求在莒县克山病重病区设立监测点。2011年选择莒县棋山镇管家坡村,2012年选择棋山镇管家坡村、龙山镇南楼村、安庄镇管家林村,2014年选择桑园镇赵家坛子村及龙山镇南楼村,2015年选择安庄镇大马家峪村、碁山镇青云庵村,进行克山病病情监测,所有观察人群进行临床查体、描记心电图和X线胸部摄片,采集部分受检人群头发及小麦、玉米、红薯干(瓜干)及各乡镇不同地理位置方位的土壤样品进行硒含量检测。同时收集莒县经济状况、人均占有粮食情况。结果四年7个调查点共调查3031人,克山病患者检出率为1.75%(53/3031),其中潜在型克山病检出率1.39%(42/3031);慢型克山病检出率0.36%(11/3031)。检出异常心电图407人,异常心电图检出率13.33%(404/3031),异常心电图以QRS波群低电压、S-T段下移、T波改变检出率最高。监测年度小麦、玉米硒含量无明显变化,居民头发硒含量却明显增高(F=2.4477 P=0.0005),2011-2012,2014-2015年居民人均经济收入和占有粮食逐渐增加,主要粮食构成中小麦、玉米的比例逐渐增加,瓜干则逐渐减少。结论莒县克山病患者检出率符合国家克山病基本控制标准,病情处于基本控制阶段。
Objective To grasp the current situation and changing trend of Keshan disease in Juxian County and provide the basis for guiding the prevention and control of the disease scientifically. Methods According to the requirements of “Implementation plan of Keshan Disease Monitoring in Shandong Province”, a monitoring point was set up in Keshan Disease Center of Juxian County. In 2011, he chose Jiajiapo Village, Qishan Town, Qixian County. In 2012, he chose Guanjiapo Village in Qishan Town, Nanlou Village in Longshan Town and Guanjia Village in Anzhuang Town. In 2014, Zhaojia Tanzi Village and Longlou Town Nanlou Village In 2015, Anjia Town, Dajiajiayu Village and Aoshan Town, Qingyunan Village were selected for monitoring Keshan Disease. All the observers were examined by clinical examination, electrocardiogram and X-ray chest radiography, and some of the subjects were collected for hair collection And wheat, corn, dried sweet potato (dried melon) and the township of different geographical position of the soil samples for selenium content detection. At the same time, we collected the economic status of Juxian County and the per capita possession of food. Results A total of 3031 people were surveyed in 7 investigation points in four years. The detection rate of Keshan disease was 1.75% (53/3031), of which the detection rate of latent Keshan disease was 1.39% (42/3031) The detection rate was 0.36% (11/3031). There were 407 abnormal electrocardiogram (ECG) and abnormal electrocardiogram (13.33%) (404/3031). The abnormal electrocardiogram showed the low voltage of QRS complex and the downward shift of S-T. The detection rate of T wave was the highest. Monitoring of annual wheat, corn selenium content had no significant change, residents hair selenium content was significantly increased (F = 2.4477 P = 0.0005), 2011-2012, 2014-2015 residents per capita economic income and possession of food gradually increased, the main food constitutes wheat , The proportion of corn gradually increased, melon stem is gradually reduced. Conclusion The detection rate of Keshan disease in Juxian County conforms to the basic control standard of Keshan Disease, and the condition is in the basic control stage.