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目的了解甘肃省不同生态类型区现存地方性克汀病(以下简称地克病)患者的生态流行病学分布特征。方法于2011年,村-乡-县逐级查阅历史地克病病例资料,对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WS 104—1999《地方性克汀病和地方性亚临床克汀病诊断》搜索和诊断历史克汀病病区及碘缺乏病高危地区1985年以后出生的地克病患者,建立甘肃省现存地克病数据库。结果 2011年全省现存地克病病例4 715例,地克病患病率为3.74/万;6个生态类型区中,荒漠区无地克病病例,秦岭中山峡谷区和黄土高原丘陵区地克病病例分别占总数的57.5%和33.2%。男、女地克病例的比例分别为70%和30%,不同生态区男性地克病病例比例均高于女性(P<0.05);新发地克病7例,其中甘南高原草原草甸区3例,其他生态区各1例;神经型、黏肿型和混合型三种病理类型的地克病病例分别占58.8%,9.8%和31.4%,河西走廊戈壁区和甘南高原草原草甸区100%为神经型,其他生态区神经型病例比例在40%~70%之间。结论甘肃省地克病病例在不同生态类型区分布特征不同,在实施全民食盐加碘防治碘缺乏病的同时,要考虑生态类型区其他因素对碘缺乏病防治的影响。
Objective To understand the ecologically epidemiological characteristics of endemic cretinism (hereinafter referred to as Dick’s disease) in different ecotypes of Gansu Province. Methods In 2011, the village-township-level county visited the historical cases of Dickett disease by level and verified and registered the historical cases of the 1985 census. At the same time, in accordance with the “High-risk Regional Surveillance Program for the Prevention and Control of Iodine Deficiency Disorders by the Central Government” and WS 104-1999 Diagnosis and diagnosis of endemic cretinism and endemic subclinical cretinism History of diagnosis and diagnosis History of cretinism and iodine deficiency disorders in high-risk areas born after 1985 Dick’s disease patients, the establishment of existing land in Gansu Province G disease database. Results In 2011, 4 715 cases of Dick’s disease were found in the province, and the prevalence rate of Dick was 3.74 per 10 000. Among the 6 ecotypes, there were no cases of Dickel’s disease in the desert area, Zhongshan Gorge area in the Qinling Mountains and hilly areas in the Loess Plateau Grams of disease cases accounted for 57.5% and 33.2% of the total. The male and female cases were 70% and 30% respectively, and the proportion of male patients with gram negative disease in different ecological zones was higher than that in female (P <0.05). There were 7 new cases of gram-negative disease, of which, 3 cases and 1 case in other ecological zones respectively. The cases of Dick’s disease with neuropathic, mucopurulent and mixed pathological types accounted for 58.8%, 9.8% and 31.4% respectively. The Gobi area of Hexi Corridor and the meadow area of Gannan plateau 100% of the neurological type, the proportion of other neurological neurological cases in 40% to 70%. Conclusion The distribution characteristics of Dicket disease in different ecotypes in Gansu Province are different. In the implementation of universal salt iodization to prevent and treat iodine deficiency disorders, the effects of other factors of ecological type on the prevention and treatment of iodine deficiency disorders should be considered.