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目的通过克山病病情调查和非克山病病区扩张型心肌病病情调查,探讨两种疾病患病情况及主要诊断方法的区别和意义。方法 2011年选择三门峡市克山病病区灵宝市开展克山病调查,选择三门峡市非克山病病区陕县开展扩张型心肌病调查;对调查对象进行临床查体和十二导联心电图描记,对疑似克山病或扩张型心肌病患者进行心动超声检查及拍摄后前位2m距离胸部正位X光片。结果调查受检率两县均大于80%,慢型克山病、扩张型心肌病病人检出率差异无统计学意义(P>0.05),克山病调查点心电图异常检出率高于扩张型心肌病调查点(P>0.01),两县心电图单项异常率差异有统计学意义的有8项,克山病调查点X线胸片增大率显著大于扩张型心肌病调查点(P<0.01),两县X线心胸比差异无统计学意义(P>0.05),两县超声心动图单项改变无差异。结论慢型克山病和扩张型心肌病的检出率相近;心电图异常检出率结果提示克山病病区人群心肌损害程度大于扩张型心肌病调查点;X线胸片检查提示克山病病区疑似病人心脏代偿性增大大于扩张型心肌病调查点,但心脏增大程度无明显差别。
Objective To investigate the difference between the two diseases and the main diagnostic methods by investigating the Keshan disease and investigating the condition of dilated cardiomyopathy in the non-Keshan disease. Methods In 2011, Kailings disease was investigated in Lingbao City, Keshan Disease District, Sanmenxia City. The investigation of dilated cardiomyopathy was carried out in Shanxian County of Non-Keshan disease in Sanmenxia City. The clinical examination and 12-lead Electrocardiogram, suspected Keshan disease or dilated cardiomyopathy echocardiography and chest anteroposterior radiographs 2m distance after radiography. Results There were no significant differences in the detection rates of chronic Keshan disease and dilated cardiomyopathy in both counties (P> 0.05). The detection rate of ECG abnormalities in Keshan disease was higher than that of dilatation Cardiomyopathy (P> 0.01). There were 8 statistically significant differences in individual ECG abnormalities between two counties. The increasing rate of X-ray of Keshan disease was significantly higher than that of dilated cardiomyopathy (P < 0.01). There was no significant difference in X-ray cardiothoracic ratio between the two counties (P> 0.05). There was no difference in echocardiography between the two counties. Conclusions The detection rates of chronic Keshan disease and dilated cardiomyopathy are similar. The detection rate of ECG abnormality suggests that the degree of myocardial damage in Keshan disease patients is greater than that of dilated cardiomyopathy. X-ray examination suggests Keshan disease Ward patients with suspected heart disease compensatory increase in dilated cardiomyopathy more than the survey, but there was no significant difference in heart enlargement.