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目的对山东省克山病病区居民进行病情与硒营养状况调查。方法 2008年选择山东的五莲、莒县、沂水、蒙阴、平邑、莒南、青州、临朐、安丘、泗水、邹城、滕州、山亭、沂源、新泰15个病区县(市、区),每个县设立1个调查点,每个点调查700人左右,对调查对象进行一般体格检查、描记心电图、后前位X线胸部摄片,同时采集病区居民的头发及小麦、玉米、地瓜干,采用2,3-二氨基萘荧光法测定硒含量。结果山东省15个县(市、区)共调查10679人,检出克山病患者315例,总检出率2.95%,总标化率2.97%,其中潜在型克山病287例,检出率2.69%,标化率2.72%;慢型克山病28例,检出率0.26%,标化率0.24%,未检出急型、亚急型患者。检出异常心电图1776例,检出率16.6%;共摄片461例,心脏增大195例,异常检出率42.3%。采集发、小麦、玉米及瓜干依次为263、270、298和258份;其硒含量依次为(0.5191±0.5538)、(0.0268±0.0045)、(0.0194±0.0052)和(0.0193±0.0039)mg/kg。结论目前山东省克山病的发病处于稳定态势,病区居民发硒达到硒适宜地区水平,内环境硒营养状况改善,克山病的患病率有望进一步降低。
Objective To investigate the status of disease and selenium nutrition among residents in Keshan disease ward of Shandong province. Methods In 2008, 15 Ward counties in Shandong Province including Wulian, Yixian, Yishui, Mengyin, Pingyi, Taonan, Qingzhou, Linqu, Anqiu, Surabaya, Zoucheng, Tengzhou, Shanting, Yiyuan and Xintai (Cities and districts). One investigation point was set up in each county and about 700 people were investigated at each point. The subjects were examined for general physical examination, electrocardiogram and posterior X-ray chest radiographs, and ward residents’ hair And wheat, corn, dried sweet potato, using 2,3-diaminonaphthalene fluorescence method for the determination of selenium content. Results A total of 10 679 people were investigated in 15 counties (cities and districts) in Shandong Province. 315 Keshan disease patients were detected, with a total detection rate of 2.95% and a total standardization rate of 2.97%. 287 cases of potential Keshan disease were detected Rate of 2.69%, the standardization rate of 2.72%; 28 cases of chronic Keshan disease, the detection rate of 0.26%, the standardization rate of 0.24%, did not detect acute, subacute patients. 1776 cases of abnormal ECG were detected, the detection rate was 16.6%; 461 cases of total radiography, 195 cases of cardiac enlargement and 42.3% abnormal detection rate. The selenium contents in the collected samples were 263, 270, 298 and 258, respectively, and the selenium contents were (0.5191 ± 0.5538), (0.0268 ± 0.0045), (0.0194 ± 0.0052) and (0.0193 ± 0.0039) mg / kg. Conclusions At present, the incidence of Keshan disease in Shandong Province is in a steady state. The incidence of selenium in residents of Ward reach the appropriate level in selenium area, the selenium nutrition in inner environment is improved, and the prevalence of Keshan disease is expected to decrease further.