摘要目的 了解阿坝州大骨节病患者疾病状况、生活现状及大骨节病防治措施实施情况.方法 2009-2011年采用分层整群抽样方法,抽取阿坝州大骨节病病区村共26个,临近非病区村12个,使用自行设计的访谈问卷入户调查病区村大骨节病患者1 347名及非病区村常住居民447名作为对照.调查内容包括:①调查对象一般人口学特征,如姓名、性别、年龄、受教育程度、家庭年收入、婚姻状况等;②大骨节病患者患病相关的基本信息,包括确诊时间、地点、治疗情况、是否拍手部X光片、是否同时患有氟斑牙、氟骨症等;③调查对象的基本生活习惯,如饮水、主食来源、主食类型、粮食存放地点、喝茶习惯等.结果 共522名(38.8％,522/1 347)大骨节病患者和12名(2.7％,12/447)对照人群确定其父母有大骨节病.绝大部分大骨节病患者(99.0％,1 334/1 347)是2～5年内在县疾病预防控制中心或县一级医院确诊,确诊后有97.6％(1 314/1 347)的患者通过服用止痛片、亚硒酸钠、维生素E进行治疗.大骨节病患者同时患氟斑牙和氟骨症的检出率分别为66.3％(893/1 347)、59.9％(807/1 347),阿坝州大骨节病患者和对照人群2004年以前主要饮用河水,主食来源是当地自产粮食(96.7％,1 716/1 774),以青稞、玉米等为主(93.5％,1 660/1 775);2004年至今水源都改为自来水,主食来源主要是两种粮食混用或者商品粮为主(96.9％,1 727/1 783),主食类型以大米和面粉为主(98.4％,1 765/1 794).94.1％(1 267/1 347)大骨节病患者有喝茶的习惯.结论 有关改水、改粮措施在阿坝地区实施较好,建议进一步采取以家庭为单位进行重点家庭宣传和防治、加强当地医疗保障体系及针对性的治疗等方式来改善当地大骨节病患者的整体患病状况及生活质量.

abstractsObjective To learn the disease status and living conditions of Kaschin-Beck disease (KBD) patients and implementation of related control measures in Aba Autonomous Prefecture,Sichuan Province.Methods A total of 26 KBD villages and 12 non-KBD villages nearby were selected in Aba Autonomous Prefecture with stratified cluster sampling method in the year of 2009 to 2011.One thousand three hundred and forty-seven KBD patients from KBD villages and 447 residents from non-KBD villages were interviewed with a self-designed questionnaire.The investigation includes:①General demographic characteristics such as name,gender,age,educational level,family income,marital status and so on.②The basic information about KBD patients including the time and location of diagnosis,treatment,hand X ray diagnosis taken or not and suffering from dental fluorosis and skeletal fluorosis.③The basic living habits such as drinking water,staple food sources,staple food types,grain storage places,tea-drinking habits and so on.Results A total of 522 (38.8％,522/1 347) KBD patients and 12 (2.7％,12/447) controls were confirmed that their parents were KBD patients.The vast majority of KBD patients (99.0％,1 334/1 347) were diagnosed in county of Chinese Center for Disease Control and Prevention or county level hospitals within 2-5 years after onset of the disease and 97.6％ of them (1 314/1 347) treated their disease by taking painkillers,sodium selenite or vitamin E.Most KBD patients had suffered from dental fluorosis (66.3％,893/1 347) and skeletal fluorosis (59.9％,807/1 347).Both the KBD patients and the controls mainly drank river water and 96.7％ of them (1 716/1 774) took locally grown food,93.5％ of them (1 660/1 775) took barley and corn as staple food in the past (before the year of 2004).But now (from the year of 2004 until now) they mainly drink tap water and 96.9％ of them (1 727/1 783) take commodity grain or two kinds of source food,98.4％ of them (1 765/1 794)changed their staple food to rice and flour.94.1％ of KBD patients (1 267/1 347) used to drink tea.Conclusions The measures of changing water and grain are well implemented in Aba Autonomous Prefecture.The government should improve the overall local KBD disease status and the quality of life of KBD patients by taking health promotion and prevention in key families,strengthening the local medical security system and targeted treatment combined with specific local conditions.