黑龙江省克山病病区内外环境硒水平及人群柯萨奇B组病毒感染现况调查

摘要

Objective To acquaint the situation of selenium nutrition level and coxsakievirus B(CVB) infection in Keshan disease(KD)patients in Heilongjiang province,and provide the evidence for taking the direction mell811rement$of KD contr01.Methods The subjeets were divided into three groups:disease area KD group, disease area control group,and non-disease area control group.We collected soil,food and blood,which were used to detect selenium content,and assay IgN antibody of CVB in plasma.The selenium content of blood was determined with hydride generation atomic fluorometry spectrometrie.The lgM antibody of CVB was measured with ELISA test Kit.Results Compared with those in non-disease areas,selenium content of soil,maize,wheat and bean(0.092 ±0.011,0.003±0.001,0.005±0.003,0.006±0.001)μg/L in disease area Welre significantly lower(t=17.007.8.551,15.842,12.109;all P<0.01).In disease area,the levels of blood selenium in disease area KD group(34.803.±13.302)μg/L was obviously decreased compared to disease area control group(41.235±13.571) μg/L (P<0.05).The rate of CVB infection among disease area KD group,control in disease area and control in non-disease area were 90.0%,68.3%and 45.8%.The odds ratio(OR) value of CVB infected exposure between disease area and non-disease areas was 3.957,and the 95% confidence interval(CI)Was 1.898～8.246.The OR value of CVB infected exposure between KD group and control group was 4.171,with the 95%CI of 1.298～13.404.Compared with CVB non-infection group,blood selenium of CVB infection group was,lower,but not significanfly(t=1.179, P>0.05).Conclusions Selenium deficiency and CVB infection still exist in KD area,Heilongjiang Province.%目的 了解黑龙江省克山病病区内外环境硒水平及柯萨奇B组病毒(CVB)人群感染情况,为采取有针对性的防治措施提供依据.方法 在克山病病区设立病区病例组和病区对照组,在非病区设立非病区对照组,采集血液样品用于检测血硒及CVB IgM抗体,同时采集病区和非病区土壤、粮食用于硒测定;硒的测定采用氢化物发生原子荧光光度法.CVB IgM抗体采用酶联免疫吸附法(ELISA)检测.结果 病区土壤、玉米、小麦、大豆含硒量[(0.092±0.011)、(0.003±0.001)、(0.005±0.003)、(0.006±0.001)mg/kg]均低于非病区[(0.198±0.016)、(0.012±0.004)、(0.037±0.007)、(0.037±0.008)mg/kg],二者比较差异均有统计学意义(t值分别为17.007、8.551、15.842、12.109,P<0.01).病区病例组血硒[(34.803±13.302)μg/L]低于病区对照组[(41.235 ±13.571)μg/L],二者比较差异有统计学意义(P<0.05);病区病例组、病区对照组、非病区对照组的CVB感染阳性率分别为90.0%(36/40)、68.3%(41/46)、45.8%(22/48),病区和非病区CVB感染的比值比(OR)为3.957,95%可信区间为1.898～8.246;病区病例组和病区对照组CVB感染的OR值为4.171,95%可信区间为1.298～13.404;CVB感染组与未感染组血硒水平比较,差异无统计学意义(t=1.179,P>0.05).结论 黑龙江省克山病病区仍存在低硒及CVB感染情况.