【摘要】 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。更多还原

【Abstract】 Objective To probe into the epidemic situation of Keshan disease(KD) in different ecotypic areas in Gansu Province during 1990～2007,in order to provide a scientific basis for the causes of Keshan disease and to regulate the preventive measures.Methods Two villages with long history of severe KD cases,Yangzhuang Village in Xihe County and Xiangming Village in Jingchuan County were selected as surveillance sites in Gansu Province in 1990～2007.The topography,meteorology and climate were observed and collected.The residents received physical examination and electrocardiography,and the suspected victims took chest X-ray examination. Meanwhile,10 hair samples from each group,children aged 3～14,women aged 18-45 and KD patients,were collected randomly to examine selenium content with hydride generation atomic fluorometer.Results The average annual incidence rate of latent KD in Yangzhuang Village and Xiangming Village was 3.84%(2.82%～7.71%) and 0.6%～1.52%respectively in 1990～1995.After the living condition was improved,the incidence rate reduced to 0～0.14%in 1997～2007,with statistical significance between the two villages in KD incidence(χ~2 = 194.066,P=0.000) and in the distribution of abnormal ECG index(χ~2 = 37.352,P<0.01).With the hair selenium content of the population increasing slowly year by year,the incidence rate of latent KD rose in Yangzhuang Village,but dropped in Xiangming Village.Conclusion The epidemic situation of KD differs in different ecotypic areas.Ladder-like inhabitation form of residents might be the ecological cause of KD.更多还原