CAJ | 학술논문

目的了解西藏大骨节病病区病情发展趋势,为大骨节病病因研究和防治提供科学依据.方法设计大骨节病调查表,于2007年7-11月,在西藏拉萨市的林周县、墨竹工卡县和山南地区桑日县的大骨节病病区,对自愿接受调查且有二代以上的家庭进行面对面的询问,并将询问结果填入调查表中;对被调查家庭中的5～14岁儿童,拍摄右手腕X线片.大骨节病诊断参照<大骨节病诊断标准>(GB 16003-1995)进行.结果共收集144个家庭,对905人进行了面谈及临床检查,检出大骨节病患者208人,总检出率为22.98%(208/905).其中Ⅰ度病人148人,占患病总人数的71.15%(148/208);Ⅱ度病人43人,占患病总人数的20.67%(43/208);Ⅲ度病人17人,占患病总人数的8.17%(17/208).拉萨市和山南地区大骨节病检出率分别为29.73%(102/343)和18.86%(106/562),两地比较差异有统计学意义(x2=15.257,P＜0.01).本次共调查男368人,女537人,男性检山率为19.29%(71/368),女性检出率为25.51%(137/537),男女检出率比较差异有统计学意义(x2=5.372,P＜0.01).大骨节病病人主要集中在31～70岁,Ⅱ、Ⅲ度病人主要见于＞40年龄段中.≤20岁年龄组中临床检出患者仅5例,5～14岁儿童X线检出患者10例,检出率为6.85%(10/146).结论拉萨市和山南地区所属的大骨节病病区病情比较稳定,并呈现下降趋势.但是在儿童中仍有X线诊断阳性病例,应引起有关部门的注意,进一步强化防制措施的落实.
목적 료해서장대골절병병구병정발전추세,위대골절병병인연구화방치제공과학의거.방법 설계대골절병조사표,우2007년7-11월,재서장랍살시적림주현、묵죽공잡현화산남지구상일현적대골절병병구,대자원접수조사차유이대이상적가정진행면대면적순문,병장순문결과전입조사표중;대피조사가정중적5～14세인동,박섭우수완X선편.대골절병진단삼조<대골절병진단표준>(GB 16003-1995)진행.결과 공수집144개가정,대905인진행료면담급림상검사,검출대골절병환자208인,총검출솔위22.98%(208/905).기중Ⅰ도병인148인,점환병총인수적71.15%(148/208);Ⅱ도병인43인,점환병총인수적20.67%(43/208);Ⅲ도병인17인,점환병총인수적8.17%(17/208).랍살시화산남지구대골절병검출솔분별위29.73%(102/343)화18.86%(106/562),량지비교차이유통계학의의(x2=15.257,P＜0.01).본차공조사남368인,녀537인,남성검산솔위19.29%(71/368),녀성검출솔위25.51%(137/537),남녀검출솔비교차이유통계학의의(x2=5.372,P＜0.01).대골절병병인주요집중재31～70세,Ⅱ、Ⅲ도병인주요견우＞40년령단중.≤20세년령조중림상검출환자부5례,5～14세인동X선검출환자10례,검출솔위6.85%(10/146).결론 랍살시화산남지구소속적대골절병병구병정비교은정,병정현하강추세.단시재인동중잉유X선진단양성병례,응인기유관부문적주의,진일보강화방제조시적락실.
Objective To assess the endemic trend of Kaschin-Beck disease in Tibet and to provide scientific basis for prevention and etiology study of the disease. Methods A questionnaire designed by us was administered to 905 participants who were from Lhundrop county, Medro Gongkar county of Lhasa municipality and Sangri county of Lhoka region in July to November, 2007. The Kashin-Beck disease diagnostic criteria(GB 16003-1995) was used for clinical diagnosis, and children 5 to 14 years old were taken right wrist X-ray film for diagnosis.Results One hundred and forty-four genealogies were recruited in this study. The interview and clinical examination were done to 905 persons, 208 persons were detected with Kaschin-Beck disease, and the detectable rate was 22.98%(208/905). The numbers of patients with degrees Ⅰ , Ⅱ and Ⅲ of Kaschin-Beck disease were 148, 43 and 17, respectively, with proportion of 71.15%(148/208), 20.67%(43/208) and 8.17%(17/208) out of all patients, respectively. The detectable rates of Kaschin-Beck disease were 29.73% (102/343) and 18.86%(106/562), respectively in Lhasa and Lhoka district, and the difference between this two districts was statistically significant(x2= 15.257, P＜ 0.01) . A total of 368 males and 537 females were recruited in this study, the detectable rates of male and female with Kaschin-Beck disease were 19.29% (71/368) and 25.51% (137/537), respectively,and the difference between male and female was statistically significant (x2 = 5.372, P ＜ 0.01) . In this study most patient were between 31 to 70 years old, the patients with degrees Ⅱ or Ⅲ of Kaschin-Beck disease were mostly above 40 years old. There were only 5 patients who were less and equal 20 years old in chinical diagnosis. The Xray positive detectable rate of children between 5 to 14 years old was 6.85% (10/146). Conclusions The condition of Kashin-Beck disease area is relatively stable in these two regions in recent years, and shows a downward trend. However, there are still positive child cases diagnosed by X-ray, which should arouse the attention of the relevant departments to further strengthen the implementation of control measures.