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目的汇总分析全国大骨节病重点监测结果,为国家和政府制定防治大骨节病策略提供科学依据。方法数据来源于1990～2007年全国大骨节病病情监测结果,将相应的数据合计,计算算术均数,然后进行省区之间的横向比较,说明全国最重病区的分布和严重程度,绘制流行严重程度和活跃程度曲线,进行长期趋势的判定和描述,分析全国宏观病情,预测未来流行趋势。结果中国大骨节病病情监测分为两个阶段。第一阶段为定点监测,监测结果可概括为4种情况:(1)开始时检出率在10%以下,观测期间基本未见波动,稳定在2%～3%;(2)开始时检出率在10%～30%的病区,在稍有波动中一路下降,到1996年即稳定在10%以下,达到基本控制的水平;(3)开始时检出率>30%的病区监测之初相当严重;这一类的病情在监测中陡然下降,直到1997年达到20%以下或更低;(4)青海省病区是中国大骨节病病区中的一个特例,X线检出率与干骺端检出率都在一个水平上,没有明显变化。第二阶段为动点监测,监测结果仍可概括为4种情况:(1)监测开始时检出率在10%以下的病区没有变化,仍然保持在控制水平。(2)监测开始时的中、重病区,如甘肃、陕西、内蒙、黑龙江在一路下迭中达到了控制水平。(3)90年代末的中国重病区青海和2000年新增加的西藏病区,也在2005年由重病区变为中等病区。(4)全国大骨节病X线检出率区间分布,控制病区由31.25%增加到82.61%、轻病区由18.75%下降到8.70%、中等病区由6.25%下降到4.35%、重病区由43.75%下降到4.35%,这说明中国的大骨节病的流行状况已经被遏制。结论中国的大骨节病在一段时间内应是以散发为主,2020年以后中国应该能够全面控制乃至消除大骨节病。
Objective To summarize and analyze the results of key monitoring results of Kaschin-Beck disease in our country and provide a scientific basis for the prevention and control of Kaschin-Beck disease by the state and government. Methods Data were collected from the national KBD disease surveillance results from 1990 to 2007. The data were summed up, the arithmetic mean was calculated, and then the horizontal comparison among provinces and autonomous regions was conducted to show the distribution and severity of the most serious ward in the country. Severity and degree of activity curve, the long-term trend of the judgment and description of the national macro-conditions, predict the future trends. Results The prevalence of KBD in China was divided into two phases. The first phase is fixed-point monitoring. The monitoring results can be summarized as four cases: (1) the detection rate is less than 10% at the beginning and basically no fluctuation during the observation period, stable at 2% -3%; (2) The rate of 10% to 30% of the ward, all the way down in a slight fluctuation, stabilized at 10% or less in 1996, reaching the level of basic control; (3) the beginning of the detection rate of> 30% of the ward The surveillance was rather serious at first stage; the incidence of this kind of diseases dropped abruptly during monitoring until it reached 20% or less in 1997; (4) Qinghai Provincial Ward was a special case of KBD in X-ray Rate and metaphysical detection rate are in a level, no significant change. The second stage is moving point monitoring. The monitoring results can still be summarized as four kinds of situations: (1) There is no change in the ward with the detection rate below 10% at the beginning of the monitoring and remains at the control level. (2) The middle and severe wards at the beginning of monitoring, such as Gansu, Shaanxi, Inner Mongolia and Heilongjiang, reached the control level in all directions. (3) Qinghai in China in the late 1990s and newly-added Tibet ward in 2000 were also changed from seriously ill areas to medium wards in 2005. (4) The range distribution of X-ray detection rate of Kashin-Beck disease in our country was from 31.25% to 82.61% in control ward, from 18.75% to 8.70% in mild ward, from 6.25% to 4.35% in moderate ward, From 43.75% to 4.35%, indicating that the prevalence of Kashin-Beck disease in China has been checked. Conclusion Kashin-Beck disease in China should be mainly exuded for a period of time. After 2020, China should be able to completely control and eliminate Kashin-Beck disease.