CAJ | 학술논문

目的：汇总青海省贵德、兴海和班玛县大骨节病病区自1982～2011年的各项监测、调查、防治和研究等结果，分析大骨节病发生、发展和影响病情消长的相关因素。方法儿童病情调查按大骨节病诊断标准进行，内外环境微量元素硒、碘、氟分别按国家或卫生行业标准进行检测，粮食T-2毒素按国家标准方法进行检测。结果贵德、兴海和班玛县大骨节病病区儿童临床患病率分别在0～55．78％、0～48．68％和0～63．38％，X线阳性检出率分别在3．96％～59.20％、0．24％～50．38％和0～52．63％。硒检测结果贵德县病区儿童发硒水平由1982年的（57．00±48．12）μg/kg上升至2010年的（182．09±78．46）μg/kg ，兴海县病区儿童发硒水平由1989年的（70．34±60．97）μg/kg上升至2010年的（211．80±86．84）μg/kg [单因素方差分析（ F检验），P＜0．05]；班玛县病区儿童发硒水平高于贵德和兴海县病区较为稳定[单因素方差分析（F检验），P＜0．05]；贵德和兴海2县外环境水、土、居民户自产主粮硒水平较低且较为稳定，班玛县外环境水、土、粮硒水平高于贵德和兴海2县且较为稳定[单因素方差分析（F检验），P＜0．05]；贵德和兴海县病区盐碘、尿碘含量均在正常范围内，水碘低于国家标准下限值。兴海县病区居民户自产主粮 T-2毒素超常聚集。贵德县病区外环境氟含量低于非病区氟含量，且病区儿童体内氟含量高于非病区儿童体内氟含量。结论贵德和兴海县病区大骨节病病情呈下降趋势但较为反复，班玛县病区大骨节病呈自然消退现象。病区复杂的环境条件、病因因素与大骨节病病情密切相关。
목적：회총청해성귀덕、흥해화반마현대골절병병구자1982～2011년적각항감측、조사、방치화연구등결과，분석대골절병발생、발전화영향병정소장적상관인소。방법인동병정조사안대골절병진단표준진행，내외배경미량원소서、전、불분별안국가혹위생행업표준진행검측，양식T-2독소안국가표준방법진행검측。결과귀덕、흥해화반마현대골절병병구인동림상환병솔분별재0～55．78％、0～48．68％화0～63．38％，X선양성검출솔분별재3．96％～59.20％、0．24％～50．38％화0～52．63％。서검측결과귀덕현병구인동발서수평유1982년적（57．00±48．12）μg/kg상승지2010년적（182．09±78．46）μg/kg ，흥해현병구인동발서수평유1989년적（70．34±60．97）μg/kg상승지2010년적（211．80±86．84）μg/kg [단인소방차분석（ F검험），P＜0．05]；반마현병구인동발서수평고우귀덕화흥해현병구교위은정[단인소방차분석（F검험），P＜0．05]；귀덕화흥해2현외배경수、토、거민호자산주량서수평교저차교위은정，반마현외배경수、토、량서수평고우귀덕화흥해2현차교위은정[단인소방차분석（F검험），P＜0．05]；귀덕화흥해현병구염전、뇨전함량균재정상범위내，수전저우국가표준하한치。흥해현병구거민호자산주량 T-2독소초상취집。귀덕현병구외배경불함량저우비병구불함량，차병구인동체내불함량고우비병구인동체내불함량。결론귀덕화흥해현병구대골절병병정정하강추세단교위반복，반마현병구대골절병정자연소퇴현상。병구복잡적배경조건、병인인소여대골절병병정밀절상관。
Objective To summarize the date of surveillance ,investigation ,prevention and research on Kash-in-Beck disease (KBD) among children from the year 1982 through 2011 in KBD regions of Qinghai Province ,in or-der to analyze the growth and decline of KBD occurrence ,development and influencing factors .Methods Survey was conducted among children with reference to the standard diagnosis of KBD .The internal and external environ-ment of trace elements including selenium ,iodine and fluorine were detected .Food T-2 toxins were determined ac-cording to the national standard method .Results The KBD prevalence rate and the X-ray detectable rate were 2.50~17 .39% ,0~13 .73% ;1 .21~8 .24% ,6 .70~23 .28% ;and 4 .26~26 .14% ,0 .80~3 .46% in Guide County , Xinghai County ,and Banma County ,respectively .The hair selenium of children rose from (57 .00 ± 48 .12)μg/kg in 1982 to (182 .09 ± 78 .46)μg/kg in 2010 in Guide County .The hair selenium of children rose from (70 .34 ± 60 .97)μg/kg in 1989 to (211 .80 ± 86 .84)μg/kg in 2010 in Xinghai County according to single factor analysis of variance (F test) ,(P<0 .05) .The hair selenium level of children in Banma County was stable and higher than that in Guide County and Xinghai County according to F test ,(P=0 .05) .Water ,soil ,household produced food selenium level was low and stable in Guide County and Xinghai County .Water ,soil ,grain selenium level in Banma County was higher than that in Guide and Xinghai ,according to F test ,( P<0 .05 ) .Salt iodine and urinary iodine levels were within the normal range in Guide County and Xinghai County ,but water iodine was lower than the national stand-ard .In Xinghai County ,the T-2 toxin in household produced food was exceedingly high .In Guide County ,the fluo-rine content of external environment was below the non -endemic area ,and the content of fluorine in children was higher than that in children in non -endemic area .Conclusions The prevalence rate declined with fluctuation in Guide County and Xinghai County ;however ,it decreased naturally in Banma County .Complex environmental fac-tors were closely related to the etiology of KBD .