不同性别非冠心病胸痛患者的临床分析  

The Clinical Analysis of Chest Pain in Patients with Non-Coronary Artery Disease in Different Gender

作　　者：雒芳玲[1] 杜学芹 张峰[2] 林文华[2] 

机构地区：[1]天津市塘沽区中医医院急诊内科,300451 [2]天津医科大学心血管病临床学院、泰达国际心血管病医院内一科

出　　处：《天津医药》2012年第1期37-39,共3页Tianjin Medical Journal

摘　　要：目的:分析不同性别的非冠心病胸痛患者的临床特征。方法:通过冠状动脉造影(CAG)/冠状动脉CT(CTCA)及单光子发射型计算机断层心肌灌注显像(SPECT-MPI)明确诊断为非冠心病胸痛的患者141例,按性别分组,对比分析2组患者的临床特点、误诊原因、病因、用药情况及精神状态。结果:141例中女85例,男56例。女性患者病史长(P<0.01),发病年龄高(P<0.05),吸烟率低,更多伴放射性疼痛及心电图ST-T改变(P<0.01)。81.2%女性和55.4%男性未及时行CAG/CTCA检查而延误诊断。功能性疾病为胸痛主要病因,不同性别差异无统计学意义(P>0.05)。排除冠心病前女性患者用药比例高于男性(P<0.01),排除冠心病后,男性和女性患者焦虑、抑郁均较排除冠心病前明显降低(P<0.01),94.9%女性和全部男性停服药物。结论:非冠心病胸痛患者临床特征存在明显的性别差异,女性更易被长期误诊。Objective：To analyze clinical features of different gender patients with chest pain and non-coronary artery disease.Methods：One hundred and forty-one non-coronary artery disease patients with chest pain were diagnosed by coronary arteriongraphy（CAG）/computerized tomography of coronary artery（CTCA） and single photon emission computed tomography myocardial perfusion imaging（SPECT-MPI）.Patients were divided into male and female groups.The clinical features,misdiagnosed cause,etiological factor,medication and mental status were analyzed in two groups.Results：There were 85 females and 56 males in 141 non-coronary heart disease patients with chest pain.There were longer history（P 0.01）,higher age of onset（P 0.05） and lower smoking rate in female patients.And they were more likely associated with radiation of pain and ST-T changes of electrocardiogram（ECG）（P 0.01）.There were delayed diagnosis in 81.2% female patients and 55.4% male patients without timely perform of CAG/CTCA examination.The functional diseases were the major cause of chest pain,and no significant difference between genders.There was a higher medication proportion before excluding coronary heart disease in female patients than that of male patients（P 0.01）.There were significantly lower patients with anxiety and depression including male and female after excluding coronary heart disease,the negative emotions with female and male patients decreased（P 0.01）.Patients of 94.9% female and 100% male suspend medication.Conclusion：The clinical characteristics of non-coronary heart disease patients with chest pain are significant gender differences.Female patients are more likely long-term misdiagnosis.

关 键 词：冠心病 心电描记术 胸痛 性别因素 情绪障碍 冠状血管造影术 体层摄影术 发射型计算机 单光子 放射性核素显像 精神病状态评定量表 

分 类 号：R472.92[医药卫生—护理学]