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目的 了解黑龙江省尚志市克山病防治现状,以及探索以较小规模调查结果来评估乡级病区范围克山病病情及其控制水平的方法.方法 2013年,选择黑龙江省克山病历史重病区的尚志市元宝镇作为调查点,在调查点内对医生和疾病预防控制中心工作人员进行问卷调查,了解克山病病区范围、病区受威胁人口情况和防控措施;通过村医、乡和县医院搜索慢型克山病疑似病例,对疑似病例进行诊断核实.选择慢型克山病病情最严重的村作为重点人群调查村,对调查村全体常住居民进行克山病病情调查,包括人口学资料收集和心电图描记等.在有潜在型克山病的调查村,抽取20～64岁男性和12岁以内男童各20名,采集发样,氢化物原子荧光光谱法检测发硒含量.结果 元宝镇共有常住人口14 862人,确诊慢型克山病患者10人,患病率为6.7/万.重点人群调查村常住人口399人,未检出急型、亚急型克山病病例;检出潜在型克山病患者10人,检出率为2.5％.分别采集成年男性和男童发样18、33份,发硒含量分别为(0.223±0.147)、(0.248±0.229)mg/kg,＜0.200 mg/kg的分别为11、17份,各占61.1％、51.5％.尚志市疾病预防控制中心有独立的地方病科室及完整的项目档案,能够按照国家要求落实克山病防控工作.结论 尚志市元宝镇克山病达到控制水平,但低硒危险因素仍然存在.小规模调查结果能够有效地评估一个乡级病区范围的克山病病情防控水平.“,”Objective To investigate the situation of Keshan disease prevention and control in Shangzhi,Heilongjiang Province,and to explore a small-scale survey method in assessing Keshan disease control measures at the scope of township of endemic areas.Methods In 2013,Yuanbao Town was chosen as the investigation site,which was a serious endemic area in history.The doctors and staff in the Center for Endemic Disease Control were surveyed to obtain the scope of the endemic areas,the population and the inplementation of Keshan disease prevention measures.Case-searching was used to search suspected cases of chronic Keshan disease at township and county hospitals and village clinics,then the diagnosis was conducted for suspected cases.The villages with the highest prevalence of chronic Keshan disease were selected as key investigation villages,demographic data,electrocardiogram and others were collected of all residents in the key investigation villages.In village with latent Keshan disease,20 adult male people aged 20 to 64 and boy under 12 years old were selected,hair samples were collected,hydride generation atomic fluorescence spectrometry was used to detect hair selenium levels.Results Yuanbao Town had 12 administrative villages with 14 862 residents.Ten cases with chronic Keshan disease were detected,the chronic Keshan disease prevalence was 6.7/10 000.Ten cases of latent Keshan disease were detected among the 399 permanent residents of the key investigation villages,and the prevalence was 2.5％.The hair samples of adult men and boys were 18 and 33.The hair selenium levels were (0.223 ± 0.147) and (0.248 ± 0.229)mg/kg,respectively,there were 11 and 17 samples which selenium levels were less than 0.200 mg/kg,accounting for 61.1％ and 51.5％,respectively.Shangzhi Center for Endemic Disease Control had a Department of Endemic Diseases and complete project records,Keshan disease prevention and control projects could be carried out in there according to the national request.Conclusions Yubao Town of Keshan disease condition has reached control level,but the risk of low selenium is still exists.This small-scale survey has effectively evaluated the status of Keshan disease prevention and control measures.