甘肃省不同生态类型区大骨节病流行现状及防治情况调查

摘要

目的 了解甘肃省不同生态类型区大骨节病流行现状及防治情况,为控制大骨节病提供生态学依据.方法 将甘肃省37个大骨节病病区县划分为4个生态类型区,每个生态类型区抽取历史病情较重的病区乡镇,每个病区乡镇抽取历史重病区村作为调查村.对调查村全部7～ 12岁儿童进行临床及右手X线拍片检查,并进行大骨节病防控措施落实情况调查.结果 4个生态类型区共调查7～ 12岁儿童27 966人,大骨节病临床检出率为0.05％(14/27 966),X线检出率为126％(353/27 966),其中干骺端检出率为1.25％(350/27 966),骨端检出率为0.01％(3/27 966),三联征检出率为0.4个生态类型区儿童临床检出率比较:陇东黄土高原沟壑区[0.09％(10/11 604)]＞陇南秦岭中山峡谷区[0.04％(3/7 969)]＞甘南高寒草原草甸区[0.02％(1/4 021)]＞陇中黄土高原丘陵区[0(0/4 372)],不同生态类型区大骨节病临床检出率比较差异无统计学意义(x2校正=7.757,P＞0.05).4个生态类型区儿童X线检出率比较:陇南秦岭中山峡谷区[1.49％(119/7 969)]＞陇东黄土高原沟壑区[1.41％(164/11 604)]＞陇中黄土高原丘陵区[0.89％(39/4 372)]＞甘南高寒草原草甸区[0.77％(31/4 021)],不同生态类型区大骨节病X线检出率比较差异有统计学意义(x2=18.133,P＜0.05).不同生态类型区大骨节病综合防控措施落实情况不同,4个生态类型区均未实施搬迁、异地 育人及补硒等措施.结论 甘肃省不同生态类型区大骨节病流行现状不同,可能与不同生态环境有关,但均处于控制状态.%Objective To grasp the epidemic features of Kaschin-Beck disease in different ecotypic areas in Gansu Province,in order to provide ecological basis for Kashin-Beck disease control.Methods Totally 37 counties with Kashin-Beck disease were divided into four ecological areas,villages with historical serious condition in township and townships with historical serious condition in county were investigated.Clinical examination and Xray of right hand of all 7-12-year-old children in the villages were carried out,while investigation of prevention and control measures was performed.Results Among 27 966 children from four ecological areas,the clinical detection rate was 0.05％ (14/27 966) and the X-ray positive rate was 1.26％ (353/27 966),metaphyseal rate was 1.25％ (350/27 966),bone-side positive rate was 0.01％ (3/27 966) and no case of epiphyseal and carpal were discovered.The clinical detection rate in children in the four ecological areas was not statistically significant (x2() =7.757,P ＞0.05),the Loess Plateau-gully region of Longdong [0.09％ (10/11 604)] ＞ the Anyon area of Qinling of Longnan [0.04％ (3/7 969)] ＞ Alpine grassland meadow area of Gannan [0.02％ (1/4 021)] ＞ the Loess Plateau-hills region of Longzhong [0 (0/4 372)].The detected rate of X-ray in four ecological areas was statistically significant (x2 =18.133,P ＜ 0.05),the Anyon area of Qinling of Longnan [1.49％ (119/7 969)] ＞ the Loess Plateau-gully region of Longdong [1.41％ (164/11 604)] ＞ the Loess Plateau-hills region of Longzhong [0.89％ (39/4 372)] ＞ Alpine grassland meadow area of Gannan [0.77％ (31/4 021)].Comprehensive prevention and control measures on Kaschin-Beck disease were different in different ecotypic areas.Relocation,long-distance education and selenium supplement measures had not been implemented in the four ecological areas.Conclusion The epidemic situation of Kaschin-Beck disease is different in different ecotypic areas in Gansu Province,which maybe related to ecological environment,but is under a state of control.