摘要目的 掌握哈尔滨市大骨节病病区范围、病情底数现况,为《全国地方病防治“十二五”规划》终期考核评估验收工作积累数据和资料.方法 2011-2015年,在哈尔滨市原有的10个大骨节病病区县(区、市)进行2次调查,每个病区县(区、市)抽取5个乡,每个乡抽取3个村,对7～ 12周岁儿童进行临床和X线检查.2013年,按《大骨节病诊断》标准,在10个大骨节病病区县(区、市),以村为单位对患病情况进行临床调查.根据各病区县(区、市)大骨节病患病情况及X线检查结果,参照《大骨节病病区控制标准》、《大骨节病病区判定和划分标准》、《重点地方病控制和消除评价办法》判定病区类型及控制和消除情况,并对防治工作组织管理进行评价.结果 哈尔滨市现有大骨节病病区县(区、市)10个,中有病区村373个,患病人数6 969人.根据病区划分和控制标准,有369个病区村符合“当地居民临床Ⅰ度及其以上患病率或7～12岁儿童X线检出率≤10％”的大骨节病轻病区标准;有4个病区村符合“当地居民临床Ⅰ度及其以上患病率或7～ 12岁儿童X线检出率＞ 10％～≤20％”的中病区标准.各病区村经临床调查,20岁以下人群中无Ⅰ度及其以上病例,7～12周岁儿童X线检出率为0,符合历史病区标准;所有病区村均无7～12周岁儿童大骨节病临床病例,儿童X线检出率为0,符合大骨节病病区村消除技术标准.各病区县(区、市)大骨节病管理指标得分为85～95分,达到了消除标准(＞ 85分)的要求.结论 哈尔滨市的大骨节病病区范围明显缩小,患病率下降,达到了病区消除标准及“十二五”规划提出的基本消除大骨节病的指标.

abstractsObjective To master the area scope and epidemic situation of Kaschin-Beck disease (KBD) in Harbin,and to accumulate data and information for the midterm examination and evaluation of "the 12th Five-Year Plan of the National Endemic Disease Prevention and Control".Methods In the original 10 counties (districts,cities) of Harbin with KBD,2 surveys were carried out from 2011 to 2015,5 townships were extracted in each county (district,city),3 villages were extracted in each township,clinical investigation and X-ray examination of 7-12 years old children were carried out;according to the criteria for "Diagnosis of Kaschin-Beck Disease",a clinical survey was conducted in 2013 in the 10 counties (districts,cities) with KBD.According to the KBD prevalence and X-ray examination results in each county (district,city),reference to "Criteria for Control of Kaschin-Beck Disease Areas","Criteria for Delimitation and Classification of Kaschin-Beck Disease Area","Evaluation Methods for Endemic Diseases Control and Elimination",the types of the disease areas,control and eliminating situation were determined;organization and management of the control and prevention measures were evaluated.Results Currently,there were 10 counties (districts,cities),373 villages,6 969 patients with KBD in Harbin.According to the KBD area division and control standard,369 villages were light KBD areas (prevalence of clinical degrees Ⅰ and above patients or detection rate of 7-12 children by X-ray for local residents ≤ 10％) and 4 villages were medium KBD areas (prevalence of clinical degrees Ⅰ and above patients or detection rate of 7-12 children by Xray for local residents ＞ 10％-≤20％).Clinical census showed that the people under 20 years had no cases with degree Ⅰ and above in each village,X-ray detection rate was 0 in 7-12 years old children,in line with the standards of history KBD areas.There were no clinical KBD cases in 7-12 years old children in all villages of KBD areas,positive detection rate of children by X-ray was 0 in the sampling KBD area villages,in line with the standards of eliminate technical standards of KBD area village.The management index scores of KBD were from 85 to 95 points in every area county (district,city),getting to the eliminating requirement which was more than 85 points.Conclusion The KBD areas have narrowed down and prevalence has declined significantly in Harbin,which has reached the area eliminating standards and the index of basically eliminating KBD proposed by "the 12th Five-Year Plan".