慢型克山病与扩张型心肌病对比研究

目的观察慢型克山病与扩张型心肌病在流行病学、临床表现及发病相关因素的异同。方法选择克山病病区自然人群170820人、非克山病病区自然人群112209人,以近5年县乡两级医院住院克山病、扩张型心肌病及两种可疑病人为线索,调查两种疾病的患病情况、临床表现和内外环境硒水平及谷胱甘肽过氧化物酶(GSH鄄Px)活性。结果慢型克山病患病率19.32/10万,扩张型心肌病患病率4.5/10万,克山病患病率显著高于扩张型心肌病(P<0.01)。慢型克山病发病年龄集中,以女性多见;扩张型心肌病发病年龄分散,以男性多见。克山病血清硒和发硒低于亲属和病区健康人(P<0.01),GSH鄄Px活性与硒呈现一致的结果(P<0.01);扩张型心肌病血清硒和发硒也低于亲属和当地健康人(P<0.01),GSH鄄Px活性与硒变化相同(P<0.01)。克山病病区健康人血清硒低于非病区健康人(P<0.05),发硒也有降低趋势,慢型克山病发硒和GSH鄄Px活性低于扩张型心肌病(P<0.05～0.01)。克山病病区小麦、玉米硒显著低于扩张型心肌病调查地区(P<0.01)。结论慢型克山病发病与低硒相关联,患病率高,女性多见,发病年龄集中;扩张型心肌病患者体内硒水平高于慢型克山病,患病率低,男性多见,发病年龄分散。二者的不同特点可为临床鉴别提供依据。

The comparative study on chronic Keshan disease and dilate cardiomyopathy

Objective To study similarities and difference in epidemiology, clinic feature, selenium (se) content and glutathione peroxidase (GSH-Px) activities on chronic keshan disease (CKSD) and dilate cardiomyopathy (DCM), in order to supply evidences of clinic diagnosis for DCM and CKSD. Methods 170 820 population in CKSD area and 112 209 population in non-CKSD area were chosen. The incidence rates of DCM and CKSD were surveyed among them. At the same time, the clinic feature, se content in and out environment and GSH-Px activities of patents with CKSD and patents with DCM were observed. Results The incidence rates of CKSD were 19.32 per million and the incidence rates of DCM were 4.50 per million. The incidence rate of CKSD was higher than that of DCM. The incidence ages of CKSD was concentrated, female more, to come on in low se area, but the incidence ages of DCM was not concentrated, male more, to come on in no low se area. Serum and fair se content of patents with CKSD were lower than that of their kinsfolk and healthy, and serum and fair se content of patents with CKSD were lower than that of their kinsfolk and healthy too. Se contents on serum and fair of healthy in CKSD area were lower than that of healthy in non-CKSD area. Varied abnormal ECG may be present in DCM and CKSD. Conclusions The similarities and difference in abnormal ECG and DCG of DCM and CKSD supply evidences for clinic diagnosis.