CAJ | 학술논문

目的：观察山东省非克山病病区扩张型心肌病病情，科学评估克山病防控效果。方法按照《全国非克山病病区扩张型心肌病病情调查方案》要求，在山东省选择自然环境、生产生活方式与克山病病区相似的7个非克山病病区县（市、区），每个县（市、区）选择1~2个乡（镇），每个乡（镇）选取1个自然村作为调查点。每个调查点对约420名居民进行详细询问病史、临床查体和心电图描记，可疑心脏异常者拍摄后前位X线胸片和心脏超声检查；同时采集部分居民内外环境样品，采用2、3二氨基奈荧光法检测硒含量；收集居民经济收入及人均占有粮食等基本情况。结果①13个自然村调查居民6463人，检出扩张型心肌病2例、类潜在型克山病111例，总检出率为1.75%（113/6463）。②描记心电图6463例，异常心电图检出率为20.39%（1318/6463），以窦性心动过缓、T波改变、窦性心动过速、ST-T改变、偶发室早、完全性右束支传导阻滞（CRBBB）、左前分支传导阻滞、房性早搏、左室面高电压、房室传导阻滞（AVB）等多见。③采集头发、小麦、玉米、土壤等样品分别为260、260、240、104份，其中头发、小麦、玉米、土壤硒含量分别为（0.353±0.082）、（0.035±0.009）、（0.024±0.008）、（0.164±0.019）mg/kg；各调查点年人均收入在2500～8670元；居民主食以面粉为主。结论山东省非克山病病区扩张型心肌病病情稳定，为国家制定克山病消除标准提供了科学的本底数据。
목적：관찰산동성비극산병병구확장형심기병병정，과학평고극산병방공효과。방법안조《전국비극산병병구확장형심기병병정조사방안》요구，재산동성선택자연배경、생산생활방식여극산병병구상사적7개비극산병병구현（시、구），매개현（시、구）선택1~2개향（진），매개향（진）선취1개자연촌작위조사점。매개조사점대약420명거민진행상세순문병사、림상사체화심전도묘기，가의심장이상자박섭후전위X선흉편화심장초성검사；동시채집부분거민내외배경양품，채용2、3이안기내형광법검측서함량；수집거민경제수입급인균점유양식등기본정황。결과①13개자연촌조사거민6463인，검출확장형심기병2례、류잠재형극산병111례，총검출솔위1.75%（113/6463）。②묘기심전도6463례，이상심전도검출솔위20.39%（1318/6463），이두성심동과완、T파개변、두성심동과속、ST-T개변、우발실조、완전성우속지전도조체（CRBBB）、좌전분지전도조체、방성조박、좌실면고전압、방실전도조체（AVB）등다견。③채집두발、소맥、옥미、토양등양품분별위260、260、240、104빈，기중두발、소맥、옥미、토양서함량분별위（0.353±0.082）、（0.035±0.009）、（0.024±0.008）、（0.164±0.019）mg/kg；각조사점년인균수입재2500～8670원；거민주식이면분위주。결론산동성비극산병병구확장형심기병병정은정，위국가제정극산병소제표준제공료과학적본저수거。
Objective To observe the dilated cardiomyopathy ( DCM ) in non-Keshan disease areas in Shandong Province and assess scientifically the effectiveness of prevention and control measures on Keshan disease (KSD). Methods According to the scheme of DCM condition survey of our country in non-Keshan disease areas, seven representative counties(cities, areas) were chosen by their similarities in natural environment, production and life style to KSD areas; one or two townships ( towns ) were chosen in each county ( city , area ); one village was selected as a survey point in each township ( town ) . In each survey point , about four hundred and twenty natural populations were checked by asking detailed history, physical examination, and electrocardiography (ECG) tracings, and suspicious people were taken chest X-ray examination and cardiac ultrasound(UCG). The samples of inside and outside environmental were collected in partial residents and the selenium contents were detected by 2,3-diaminonaphthalene fluorometric method. At the same time the income, food of inhabitant and other basic information were collected. Results ① In 13 survey villages, sixty-four hundred and sixty-three residents were surveyed and 2 DCM cases and 111 similar potential KSD cases were detected, the detection rate was 1.75%(113/6 463). ② Sixty-four hundred and sixty-three residents were traced by ECG and the incidence of abnormal ECG was 20.4%(1 318/6 463), and sinus bradycardia, T-wave changes, sinus tachycardia, ST-T changes, occasional ventricular beating earlier, complete right bundle branch block, left anterior branch block, room premature beat, left ventricular high voltage, auriculo-ventricular block, et al were common. ③Samples of hair(260), wheat(260), corn (240) and soil (104) were collected, and the selenium contents were (0.353 ± 0.082), (0.035 ± 0.009), (0.024 ± 0.008) and (0.164 ± 0.019)mg/kg, respectively. Annual per capita income of each survey point was 2 500-8 670 yuan, and the residents’ main staple food was flour. Conclusion The results of DCM condition in non-Keshan disease areas of Shandong Province are stable and have provided a scientific basis for drawing up the national standard of eliminating KSD.