CAJ | 학술논문

目的观察1990-2007年河北省克山病病情动态变化,为制订防治措施提供科学依据.方法采用回顾性方法,对河北省疾病预防控制中心地方病防治所1990-2007年按照<全国克山病病情监测方案>和<克山病监测>(W/T 78-1996)所进行的克山病病情监测资料,对克山病临床体检结果、心电图检查情况、克山病病人及疑似病人胸部X线检查资料,以及1990、1992和1999年的发硒检测结果进行分析.结果 1990-2007年监测点无急型、亚急型克山病病人发生,共新发潜在型克山病病人35例,新发自然慢型克山病病人1例,慢型克山病检出率范围为1.12℃(8/713)～8.18%(27/330),潜在型克山病检出率范围为2.29%(19/831)～8.20%(45/549),3～14岁儿童和20～45岁育龄妇女克山病检出率逐年下降,45岁以上人群成为当前克山病患病主体.克山病患者主要心电图异常改变为完全性右束支传导阻滞、ST-T改变、频发性室性早搏和左前分支传导阻滞,克山病患者心脏增大检出率平均为47.00%(211/449),2005年后心脏中度以上增大检出率显著增加[28.57%(8/28)～48.39%(15/31)].1990-2007年慢型克山病死亡率平均为18.00%(18/100).结论河北省克山病病情呈缓慢下降趋势,病情处于相对稳定状态.河北省仍是全国克山病病情较重的地区,克山病防治任务还很艰巨,加强克山病病情监测和开展克山病的管理与治疗是防治工作的重点.
목적 관찰1990-2007년하북성극산병병정동태변화,위제정방치조시제공과학의거.방법 채용회고성방법,대하북성질병예방공제중심지방병방치소1990-2007년안조<전국극산병병정감측방안>화<극산병감측>(W/T 78-1996)소진행적극산병병정감측자료,대극산병림상체검결과、심전도검사정황、극산병병인급의사병인흉부X선검사자료,이급1990、1992화1999년적발서검측결과진행분석.결과 1990-2007년감측점무급형、아급형극산병병인발생,공신발잠재형극산병병인35례,신발자연만형극산병병인1례,만형극산병검출솔범위위1.12℃(8/713)～8.18%(27/330),잠재형극산병검출솔범위위2.29%(19/831)～8.20%(45/549),3～14세인동화20～45세육령부녀극산병검출솔축년하강,45세이상인군성위당전극산병환병주체.극산병환자주요심전도이상개변위완전성우속지전도조체、ST-T개변、빈발성실성조박화좌전분지전도조체,극산병환자심장증대검출솔평균위47.00%(211/449),2005년후심장중도이상증대검출솔현저증가[28.57%(8/28)～48.39%(15/31)].1990-2007년만형극산병사망솔평균위18.00%(18/100).결론 하북성극산병병정정완만하강추세,병정처우상대은정상태.하북성잉시전국극산병병정교중적지구,극산병방치임무환흔간거,가강극산병병정감측화개전극산병적관리여치료시방치공작적중점.
Objective To observe the dynamic changes of prevalence of Keshan disease (KD) in Hebei province from 1990 to 2007, to provide scientific basis for its prevention and treatment. Methods The surveillance data of KD was analyzed according to "the National Scheme of KD Surveillance and the Surveillance of KD" (W/T 78-1996) in Hebei province from 1990 to 2007 by the Institute for Prevention of Endemic Disease in Hebei Province Center for Disease Control and Prevention. The data included physical examination, electrocardiogram (ECG), the chest X-ray film of KD patients and the suspected patients, as well as selenium contents of hair collected in 1990, 1992 and 1999. Results No new cases of acute and subacute types of KD patients were found at the surveillance sites from 1990 to 2007. Thirty-five cases of new latent KD and one case of spontaneous chronic KD were identified respectively. Prevalence of chronic and latent KD ranged from 1.12% (8/713) to 8.18% (27/330) and 2.29% (19/831) to 8.20% (45/549) in Hebei province from 1990 to 2007, respectively. The prevalence of KD in children aged 3 - 14 years old and childbearing woman aged 20 - 45 years old decreased year by year, however population over 45 years old were more likely suffering from KD. The major abnormal changes of ECG in KD) patients were complete fight bundle branch block, ST-T change frequent premature ventricular contraction, and left anterior faseicular block. The prevalence of the heart enlargement in KD patients was 47.00% (211/449) averagely, and the prevalence of heart enlargement of medium grade increased remarkably after 2005 [28.57%(8/28) - 48.39%(15/31)]. The average mortality in chronic KD patients was 18.0%(18/100) from 1990 to 2007. Conclusions The prevalence of KD decreased slowly in Hebei province. Hebei province is still the region with higher prevalence of KD around the country, and the tasks of prevention and treatment of KD is still urgent. Enhancing the surveillance of of KD and carrying out management and treatment of KD patients should be emphasized in the future.