CAJ | 학술논문

目的初步建立地方性克汀病(地克病)资料库,了解甘肃省现存地克病分布情况,为碘缺乏病防治提供建议.方法 2011年,按照村-乡-县逐级查阅历史地克病病例资料,对甘肃省1985年普查的历史病例进行核实和登记,同时按照《中央转移支付碘缺乏病防治项目的高危地区监测方案》和《地方性克汀病和地方性亚临床克汀病诊断》(WS 104-1999),搜索和诊断历史地克病病区和碘缺乏病高危地区1985-2011年的地克病患者,建立甘肃省现存地克病数据库,分析现存地克病的分布情况.结果 1985年甘肃省地克病县(区)为53个,地克病病例为19 696例;2011年甘肃省地克病县(区)为41个,地克病病例4 715例,其中1985年前出生的地克病病例4 690例,1985-1997年出生的地克病18例,1997后出生(新发)地克病7例.在4 708例历史病例中,神经型、黏肿型和混合型地克病的比例分别为58.8％(2 766/4 708)、9.8％(461/4 708)和31.4％(1 481/4708),男性和女性地克病的比例分别为69.3％(3 261/4708)和30.7％(1 447/4 708),45岁以上病例占73.2％(3444/4 708);新发7例地克病均为神经型,5例分布在少数民族地区.结论甘肃省目前还存在碘缺乏病高危地区,有发生地克病的潜在危险.甘肃省神经型地克病居多,主要是由于母体怀孕早期碘摄入不足所造成的,适时向高危地区的孕妇和哺乳期妇女提供应急补碘强化措施是防止地克病新发的关键.
목적 초보건입지방성극정병(지극병)자료고,료해감숙성현존지극병분포정황,위전결핍병방치제공건의.방법 2011년,안조촌-향-현축급사열역사지극병병례자료,대감숙성1985년보사적역사병례진행핵실화등기,동시안조《중앙전이지부전결핍병방치항목적고위지구감측방안》화《지방성극정병화지방성아림상극정병진단》(WS 104-1999),수색화진단역사지극병병구화전결핍병고위지구1985-2011년적지극병환자,건립감숙성현존지극병수거고,분석현존지극병적분포정황.결과 1985년감숙성지극병현(구)위53개,지극병병례위19 696례;2011년감숙성지극병현(구)위41개,지극병병례4 715례,기중1985년전출생적지극병병례4 690례,1985-1997년출생적지극병18례,1997후출생(신발)지극병7례.재4 708례역사병례중,신경형、점종형화혼합형지극병적비례분별위58.8％(2 766/4 708)、9.8％(461/4 708)화31.4％(1 481/4708),남성화녀성지극병적비례분별위69.3％(3 261/4708)화30.7％(1 447/4 708),45세이상병례점73.2％(3444/4 708);신발7례지극병균위신경형,5례분포재소수민족지구.결론 감숙성목전환존재전결핍병고위지구,유발생지극병적잠재위험.감숙성신경형지극병거다,주요시유우모체부잉조기전섭입불족소조성적,괄시향고위지구적잉부화포유기부녀제공응급보전강화조시시방지지극병신발적관건.
Objective To build a case database of endemic cretinism,investigate the distribution of existing cretinism,and provide suggestions for prevention of iodine deficiency disorders.Methods In 2011,an existing endemic cretinism case database was established in Gansu Province by verifying and registering the historical cases before 1985,and searching and diagnosing the cases between 1985-2011 in history cretinism areas and IDD high-risk areas according to "endemic cretinism and endemic sub-clinical cretinism diagnosis (WS 104-104)" and "the IDD monitoring program of the central transfer fund" at the same time,and analysis the distribution of existing cretinism.Results In 1985 and 2011,cretinism areas were 53 and 41 in Gansu Province,and the endemic cretinism cases werel9 696 and 4 715,respectively;18 cases of endemic cretinism were born between 1985 to1997,7 new cases were born after 1997;nerve cretinism,myxedematous and mixed types among existing cases were 58.8％ (2 766/4 708),9.8％ (461/4 708) and 31.4％ (1 481/4 708),males and females were 69.3％ (3 261/4 708)and 30.7％ (1 481/4 708),respectively.Cases older than 45 accounted for 73.2％ (3 444/4 708);the 7 new cases were all nerve cretinism and 5 cases distributed in ethnic minority areas.Conclusions There are potential dangers of endemic cretinism in the high-risk areas of iodine deficiency disorders due to multiple factors in Gansu Province;the nervous cretinism is the majority which is caused by insufficient iodine intake in early maternal pregnancy.To prevent new endemic cretinism,it is necessary to strengthen measures of emergency iodine supplementation for pregnant women and nursing mothers in the high-risk areas.