摘要
目的掌握河北省张家口市克山病病情和相关危险因素,为精准防控克山病提供科学依据。方法按照《河北省地方病防治专项攻坚行动方案》(冀卫疾控函[2019]2号)和《河北省克山病监测实施方案(2019版)》要求,于2019—2021年在张家口市8个病区(县)的病区乡以病区村为单位开展克山病病情监测工作,对调查人群进行临床查体、心电图描记、心脏超声和X线胸片检查。依据《国家重点地方病控制和消除评价办法(2019版)》进行克山病病区达标情况判定。同时,2019年在7个病区(县)和2个非病区(县)开展人群头发硒、粮食硒含量调查,采集儿童、成年人头发样品和主食粮样品进行硒含量检测。结果2019—2021年,张家口市的31个病区乡(镇)有现症克山病患者51例,其中慢型克山病患者8例(15.69%),潜在型克山病患者43例(84.31%),以潜在型克山病病例为主,无新发克山病患者。共对1487例疑似克山病病例进行了心电图描记,异常率为39.35%(585/1487);心脏超声检查724例,异常率为20.72%(150/724);拍摄X线胸片91例,心脏增大率为53.85%(49/91)。共采集头发样品270份,发硒含量均值为(0.351±0.101)mg/kg,处于硒营养中等水平。非病区(县)人群发硒含量均值为(0.367±0.081)mg/kg,高于病区(县)的(0.346±0.106)mg/kg,差异无统计学意义(P>0.05)。270份粮食样品中,非病区(县)硒含量均值[(0.050±0.070)mg/kg]高于病区(县)[(0.039±0.037)mg/kg],差异无统计学意义(P>0.05)。结论张家口市低硒等健康危险因素得到了弱化,克山病病情达到消除标准,今后应继续落实综合防治措施,加强慢型克山病患者的治疗和管理,建议将其治疗和随访管理纳入慢性非传染性疾病管理和医疗保险,提高慢型克山病患者的生活质量和延长慢型克山病患者的寿命。
Objective To understand the prevalence of Keshan disease and related risk factors in Zhangjiakou,Hebei province,and provide evidence for the accurate prevention and control of Keshan disease.Methods According to the endemic disease prevention and treatment plan(2019)and the Keshan disease surveillance plan in Hebei(2019 edition),Keshan disease surveillance was conducted in villages or townships in 8 counties or districts where Keshan disease was endemic in Zhangjiakou during 2019–2021,in which clinical health examination,including electrocardiogram(ECG),cardiac ultrasound and X-ray chest examinations,was conducted for local residents.According to the national requirement of control and elimination of major endemic diseases(2019 edition),the prevalence of Keshan disease in the 8 counties or districts was evaluated.At the same time,in 2019,hair selenium and grain selenium content surveys were conducted in 7 Keshan disease endemic counties or districts and 2 non-Keshan disease endemic counties or districts in Zhangjiakou,and the hair samples of children and adults and main food samples were collected for selenium content testing.Results From 2019 to 2021,a total of 51 Keshan disease cases were found in 31 townships in Keshan disease endemic areas in Zhangjiakou,including 8 chronic cases(15.69%)and 43 potential cases(84.31%).No new Keshan disease cases was found.ECG examination was given for 1487 suspected Keshan disease cases,and the abnormal rate was 39.35%(585/1487).Cardiac ultrasound examination was given for 724 suspected Keshan disease cases,and the abnormal rate was 20.72%(150/724).Chest X-ray examination was given for 91 suspected Keshan disease cases,and the cardiac enlargement rate was 53.85%(49/91).A total of 270 hair samples were collected,and the mean selenium content was(0.351±0.101)mg/kg,indicating a moderate level of selenium nutrition.The mean selenium content[(0.367±0.081)mg/kg]in population in the non-disease endemic area was higher than that in population in the disease endemic area[(0.346±0.
作者
郝丽萍
李丽
谷海军
张海霞
韩国义
Hao Liping;Li Li;Gu Haijun;Zhang Haixia;Han Guoyi(Zhangjiakou Institute of Endemic Disease Control and Prevention,Zhangjiakou 075000,Hebei,China;Zhangjiakou Medical Security Audit Affairs Center,Zhangjiakou 075000,Hebei,China;Institute of Bacterial Disease Control and Disinfection,Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang 050021,Hebei,China)
出处
《疾病监测》
CAS
CSCD
北大核心
2023年第8期972-976,共5页
Disease Surveillance
基金
河北省医学科学研究计划课题(No.20201596)。
关键词
克山病
病情监测
硒营养水平
Keshan disease
Disease surveillance
Selenium nutrition level
