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目的观察克山病病情和发病相关因素动态变化,为科学的指导克山病防治研究提供依据。方法在山东克山病重病区莒县安庄和邹城市张庄设立2个监测点,自2000年起对3~14岁的1049例多发人群和点区县克山病病情进行连续5年动态监测,观察人群全部进行临床检查、心电图检查,可疑病人行X线胸部摄片,并对监测居民内、外环境(发、小麦、玉米、地瓜干)硒水平、经济情况及人均占有粮食进行了调查。结果5年间2县无急型、亚急型发病,原有慢型97例,死亡10例,新发病5例。多发人群克山病检出率2000、2002及2004年安庄点依次为3.31%、4.86%、4.45%,张庄点为3.69%、4.86%、4.45%。异常心电图检出率2000、2002及2004年安庄点依次为3.31%,7.16%,5.39%;张庄点为6.38%,4.55%,5.27%。发硒水平逐年升高,粮食硒含量基本恒定。经济收入和人均占有口粮逐年增加,达137.9%~260.0%。结论5年间克山病多发人群和点区县病情无明显变化,发病相关因素不断改善。
Objective To observe the dynamic changes of Keshan disease and related factors, and provide the basis for the scientific research of Keshan disease prevention and control. Methods Two monitoring sites were set up in An Zhuang County, Lixian County, Shandong Province and Zhangzhuang City, Zoucheng City, Shandong Keshan Severe Diseases. From 2000 onwards, 1049 multi-populations from 3 to 14 years old and Keshan disease in Dianqu County were monitored continuously for 5 years. , Observed all the population for clinical examination, electrocardiogram, suspicious patients X-ray chest radiography, and to monitor the residents within and outside the environment (hair, wheat, corn, dried sweet potato) selenium levels, economic conditions and per capita possession of food were investigated . Results No acute and subacute morbidity occurred in 2 counties in 5 years. There were 97 cases of chronic type, 10 cases of death and 5 cases of new onset. The detection rate of Keshan disease in multiple population was 3.31%, 4.86% and 4.45% in Anpingzhuang in 2000, 2002 and 2004, respectively, while Zhangzhuang point was 3.69%, 4.86% and 4.45% respectively. The detection rate of abnormal electrocardiogram was 3.31%, 7.16% and 5.39% respectively in 2000, 2002 and 2004, while that of Zhangzhuang was 6.38%, 4.55% and 5.27% respectively. Hair selenium levels increased year by year, grain selenium content is basically constant. Economic income and per capita food rations increased year by year, reaching 137.9% -260.0%. Conclusions There is no significant change in Keshan disease-prone population and point-counties in the past five years, and the incidence-related factors are continuously improved.