不同性别急诊非创伤性胸痛患者的临床特点及病因分析

发布时间：2018-04-25 21:47

本文选题：胸痛 + 急诊处理　；参考：《中国全科医学》2016年29期

【摘要】：目的探讨不同性别急诊非创伤性胸痛患者的临床特点及病因。方法选择2013年6月—2015年7月兵器工业521医院接诊的以急性非创伤性胸痛为主诉就诊的患者384例,将其按照性别分为男性组(n=206)和女性组(n=178),比较两组患者基本资料、胸痛特点(包括疼痛诱因、疼痛部位、疼痛性质、疼痛持续时间、有无放射痛或并发症等)、胸痛病因(包括心源性、肺源性、主动脉夹层、胃肠源性、带状疱疹、原因不明确等)、心电图、超声心动图等临床资料。结果两组患者高血压病史、糖尿病病史、高血脂病史比较,差异均无统计学意义(P0.05);两组患者年龄、吸烟史、饮酒史比较,差异均有统计学意义(P0.05)。两组患者疼痛部位、有无放射痛比较,差异均无统计学意义(P0.05);两组患者疼痛诱因、疼痛性质、疼痛持续时间、有无并发症比较,差异均有统计学意义(P0.05)。男性组中胸痛病因分别为心源性84例(40.78%)、肺源性62例(30.10%)、主动脉夹层9例(4.37%)、胃肠源性37例(17.96%)、带状疱疹3例(1.46%)、原因不明确11例(5.33%);女性组中胸痛病因分别为心源性61例(34.27%)、肺源性53例(29.78%)、主动脉夹层7例(3.93%)、胃肠源性20例(11.24%)、带状疱疹4例(2.25%)、原因不明确33例(18.53%)。两组患者胸痛病因构成比较,差异有统计学意义(χ2=27.228,P0.05)。两组患者心电图ST-T改变、超声心动图中左心室舒张功能降低、左心室射血功能降低、室壁运动异常发生率比较,差异均无统计学意义(P0.05)。男性患者18~30岁胸痛病因主要是胃肠源性(66.67%),31~50岁、51~70岁、71~82岁胸痛病因主要是心源性(分别为37.10%、50.67%、53.85%)。女性患者18~30岁胸痛病因主要是胃肠源性(29.41%),31~50岁胸痛病因主要是原因不明确(31.33%),51~70岁、71~82岁胸痛病因主要是心源性(分别为45.10%、51.85%)。结论男、女性急诊非创伤性胸痛病因均以心源性胸痛为主,男性患者年龄大者所占比例较女性高,且多有吸烟史和饮酒史,此类患者在临床诊治过程中应根据疾病特点及时准确治疗。
[Abstract]:Objective to investigate the clinical characteristics and etiology of non traumatic chest pain in emergency patients. Methods 384 patients with acute non traumatic chest pain in 521 hospital from June 2013 to July 2015 were treated with acute non traumatic chest pain. They were divided into male group (n=206) and female group (n=178) according to sex. The basic data of the two groups were compared. Pain characteristics (including pain inducement, pain site, pain nature, pain duration, radiation pain or complications), the etiology of chest pain (including cardiogenic, pulmonary origin, aortic dissection, gastrointestinal origin, herpes zoster, cause is not clear, etc.), ECG, echocardiography, and other clinical data. Results two groups of patients with history of hypertension, diabetes, history, The difference in the history of hyperlipidemia was not statistically significant (P0.05). The difference in age, smoking history and drinking history of the two groups was statistically significant (P0.05). There was no significant difference between the two groups of pain sites, without radiation pain (P0.05), and the two groups of pain causes, pain nature, pain duration, and no complications, The differences were statistically significant (P0.05). The causes of chest pain in the male group were 84 cases (40.78%), 62 cases of pulmonary origin (30.10%), 9 cases of aortic dissection (4.37%), 37 cases of gastrointestinal origin (17.96%) and 3 cases of herpes zoster (1.46%). The causes were 11 (5.33%), and the causes of chest pain in the female group were respectively cardiogenic 61 cases (34.27%) and pulmonary origin cases, respectively. 7 cases (3.93%) of aortic dissection, 20 cases of gastrointestinal origin (11.24%), 4 cases of herpes zoster (2.25%) and 33 cases (18.53%). The difference was statistically significant (x 2=27.228, P0.05) in two groups. The ECG ST-T changes in the two group, the lower left ventricular diastolic function in the hyper cardiogram, the lower left ventricular ejection function, the ventricular wall There was no significant difference in the incidence of dyskinesia (P0.05). The main causes of 18~30 years old chest pain in male patients were gastrointestinal origin (66.67%), 31~50 years old, 51~70 years old. The main causes of 71~82 years old chest pain were cardiogenic (respectively 37.10%, 50.67%, 53.85%). The main causes of 18~30 years old chest pain in female patients were gastrointestinal origin (29.41%), and the main cause of 31~50 years of chest pain was the main cause. If the cause is not clear (31.33%), 51~70 years old, the cause of 71~82 years old chest pain is mainly cardiogenic (45.10%, 51.85%). Conclusion male, the main causes of non traumatic chest pain in women are cardiac pain, the proportion of older men is higher than that of women, and there are more smoking and drinking history, such patients should be rooted in the process of clinical diagnosis and treatment. According to the characteristics of the disease, timely and accurate treatment.

【作者单位】：兵器工业521医院急诊科;
【分类号】：R441

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