地方性克山病：一种食源性骨关节炎。

Endemic Kashin-Beck disease: A food-sourced osteoarthropathy.

机构信息

Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, 157 Baojian Road, Harbin 150081, People's Republic of China; Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Harbin Medical University, Harbin, People's Republic of China; China and Russia Medical Research Center, Harbin Medical University, Harbin, People's Republic of China; Harbin Medical University, Harbin, People's Republic of China.

出版信息

Semin Arthritis Rheum. 2020 Apr;50(2):366-372. doi: 10.1016/j.semarthrit.2019.07.014. Epub 2019 Aug 2.

DOI:10.1016/j.semarthrit.2019.07.014

PMID:31548049

Abstract

OBJECTIVE

Kashin-Beck disease (KBD) is an endemic osteoarthropathy, which causes disability and heavy socioeconomic burdens. The preventive measures have been taken in the past few decades. However, recent KBD-epidemiological trend and comprehensive effect of its preventive measures need to be evaluated.

METHODS

By employing typical survey, cross-sectional survey, case-control study, intervention trial, and national surveillance, the present study summarizes comprehensive role of KBD-preventive measures.

RESULTS

The endemic KBD is distributed in a long and narrow area of the world. The latest epidemic began in the late 1950s and lasted until the end of 1980s. Epidemiology of the KBD was characterized by early-onset, gender equality, agricultural area, regional discrepancy, family aggregation, annual fluctuation, etc. Multivariate regression analysis suggested that etiology of the KBD was food-related factors such as fungal contamination of grains, selenium deficiency, imbalance of protein intake, etc. A series of intervention measures for KBD control had been implemented since 1990s, and involved more than 300 million residents. National incidences were 22.1% in 1990, 16.0% in 1995, 12.3% in 2000, 5.5% in 2005, 0.38% in 2010, and 0.18 in 2015, respectively. Although new patients were annually decreased, it still affected 22,567,600 inhabitants and there were 574,925 patients in 2016.

CONCLUSIONS

Etiology of the KBD is food-sourced. Its decreased incidence may attribute to an effective implementation of preventive measures. It is possible to eradicate KBD from the earth in the near future.

摘要

目的

大骨节病（KBD）是一种地方性骨关节病，会导致残疾和沉重的社会经济负担。过去几十年已经采取了预防措施。然而，最近的 KBD 流行病学趋势和其预防措施的综合效果仍需要评估。

方法

通过采用典型调查、横断面调查、病例对照研究、干预试验和国家监测，本研究总结了 KBD 预防措施的综合作用。

结果

地方性 KBD 分布在一个狭长的世界区域。最新的流行始于 20 世纪 50 年代末，一直持续到 80 年代末。KBD 的流行病学特征为发病早、性别平等、农业区、地区差异、家庭聚集、年度波动等。多元回归分析表明，KBD 的病因与真菌污染谷物、硒缺乏、蛋白质摄入失衡等食物相关因素有关。自 20 世纪 90 年代以来，已经实施了一系列的 KBD 控制干预措施，涉及 3000 多万居民。1990 年全国发病率为 22.1%，1995 年为 16.0%，2000 年为 12.3%，2005 年为 5.5%，2010 年为 0.38%，2015 年为 0.18%。虽然每年新增病例数都在减少，但仍有 2256.76 万人受到影响，2016 年患者人数为 574925 人。