Xiang You-Zhang, Wang Xiu-Hong, Song Shu-Liang, Qü Fu-Rong, Wang Lin, Guan Shu-Fen
Shandong Institute for Prevention and Treatment of Endemic Disease, Jinan 250014, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2008 Jul;42(7):527-30.
To observe the serial changes of condition and related factors of Keshan disease (KSD) and provide the scientific basis for disease control and further research.
The villages in KSD epidemic area of Juxian, Yishui, Pingyi, Zoucheng counties were selected. Since 1990, every five-year was counted as a stage. For the first to third stage, 3-14 year-old residents and over 14 year-old suspicious patients were selected as surveillance subjects. And in the fourth stage, all residents were selected as surveillance subjects. The same group of surveillance subjects in each stage were observed consecutively for 5 years. Surveillance contents included physical checkup, electrocardiogram (ECG) and Xray. At the same time, the selenium (Se) concentration in hair, wheat, corn and sweet potato was measured. The economic income and grain availability were also investigated.
Totally, 14,510 cases were visited during 18 years. The incidence of KSD was 3.02% in the first stage, 2.31% in the second stage, 3.57% in the third stages and 3.65% in the fourth stage. Totally, 14,510 cases were examined by ECG, 809 cases showed the abnormal ECG and the total incidence of abnormal ECG was 5.49%. The incidence of abnormal ECG was 3.52% -5.24% from 1990 to 2004 but was 10.97%-10.91% from 2005 to 2007. 732 of hair samples, 701 of wheat samples, 615 of corn samples and 643 of sweet potato samples were collected and the Se concentration was determined by the fluorescent method. Se levels in hair samples had increased (P < 0.05) year by year but Se levels in food have not changed significantly. The economic income and grain availability had increased gradually from 535.8 yuan and 254.6 kg per person in 1990 to 2968.0 yuan and 602.0 kg per person in 2007.
The condition of KSD was in a stable situation in Shandong Province. Related factors improvement should be an important environmental condition.
观察克山病病情及相关因素的动态变化，为克山病防治及进一步研究提供科学依据。
选取莒县、沂水县、平邑县、邹城市克山病病区的村庄。自1990年起，每5年为一个阶段。第一至第三阶段，选取3 - 14岁居民及14岁以上可疑患者作为监测对象；第四阶段，选取所有居民作为监测对象。各阶段同一组监测对象连续观察5年。监测内容包括体格检查、心电图（ECG）及X线检查。同时，测定头发、小麦、玉米和红薯中的硒（Se）含量。并调查经济收入和粮食供应情况。
18年间共走访14510例。第一阶段克山病发病率为3.02%，第二阶段为2.31%，第三阶段为3.57%，第四阶段为3.65%。共对14510例进行了心电图检查，809例心电图异常，心电图异常总发生率为5.49%。1990 - 2004年心电图异常发生率为3.52% - 5.24%，2005 - 2007年为10.97% - 10.91%。采集头发样本732份、小麦样本701份、玉米样本615份、红薯样本643份，采用荧光法测定硒含量。头发样本中的硒含量逐年升高（P < 0.05），但粮食中的硒含量无明显变化。经济收入和粮食供应从1990年人均535.8元、254.6公斤逐渐增加到2007年人均2968.0元、602.0公斤。
山东省克山病病情处于稳定状态。改善相关因素应是重要的环境条件。
