需与急性冠状动脉综合征鉴别的双硫仑反应  

Identification of acute coronary syndrome and disulfiram reaction

作　　者：王津生[1] 

机构地区：[1]河南省新乡市中心医院心内2科,453000

出　　处：《中国实用医刊》2012年第13期9-10,共2页Chinese Journal of Practical Medicine

摘　　要：目的提高对伴胸痛的双硫仑反应的认识，减少误诊。方法收集国内近几年公开发行的100余种医药期刊报道的以及新乡市中心医院诊疗的双硫仑反应病例进行分类统计分析。结果5333例双硫仑反应患者中除具有双硫仑反应的一般症状：面色潮红、心悸、头痛、恶心、呕吐、头晕、呼吸困难、气促等，易于冠心病、心绞痛混淆的临床表现有：胸闷3490例（65．4％）、窦性心动过速2476例（46．4％）、血压下降1448例（27．2％）、大汗1044例（18．8％）、胸痛663例（12．4％）、心电图ST—T改变622例（11．7％）、濒死感162例（3％），多数患者被误诊为“急性冠脉综合征”，甚至行急诊冠状动脉造影检查。大部分患者经修正诊断，按双硫仑反应治疗后，预后良好。结论对胸痛伴面色潮红的疑似急性冠状动脉综合征的患者，要详细追问近期应用药物和含醇制品史，避免误诊。Objective To improve the recognition of disulfiram reaction with chest pain, and reduce misdiagnosis. Methods The cases of disulfiram reaction reported in 100 periodicals which published in recent years and admitted in Xinxiang central hospital were collected, and analyzed statistically. Results The clinical manifestations of 5333 cases of disulfiram reaction patients except with disulfiram reaction of general symptoms ： pale complexion, palpitation, headache, nausea, vomiting, dizziness, dyspnea, shortness of breath and so on; the clinical manifestations easy to be confused with coronary heart disease were chest distress in 3490 cases （65.4%） , sinus tachycardia in 2476 cases （46.4%） , hypo- tension in 1448 cases （27.2%）, perspiration in 1044 cases （18.8%）, chest pain in 663 eases （12.4%） , ST-T of ECG changes in 622 cases （ 11.7% ） , feeling of impending death in 162 cases （3%） , the majority of patients were misdiagnosed as acute coronary syndrom, even with emergency coronary artery angiography. The prognosis of most of the patients was good after modified diagnosis by exactly treating disulfiram reaction. Conclusions We should detailed asking the history of drug use and alcohol containing products in suspected acute coronary syndrome patients with chest pain and flushed face, in order to avoid the misdiagnosis.

关 键 词：双硫仑反应 胸痛 饮酒 急性冠状动脉综合征 

分 类 号：R473.5[医药卫生—护理学]