抑酸试验在酸相关非心源性胸痛中的应用  

Application of proton pump inhibitor test in acid related non-cardiac chest pain

作　　者：余志金[1] 陈惠新[1] 罗程[1] 徐永成[1] 严山[1] 凌红[1] 

机构地区：[1]广东省惠州市中心人民医院消化内科,广东惠州516001

出　　处：《胃肠病学和肝病学杂志》2013年第11期1108-1109,共2页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨质子泵抑制剂(PPI)诊断性治疗(抑酸试验)在酸相关非心源性胸痛(NCCP)中的应用价值。方法收集因胸痛接受冠状动脉造影的69例NCCP症状人群,所有患者均填写中文版反流疾病调查问卷(RDQ)。胃镜检查和/或24 h食管pH监测阳性者即为酸相关NCCP,入选观察组,阴性者为对照组。观察组和对照组均予埃索美拉唑20 mg/次,2次/d,疗程1周。治疗前、后观察记录烧心程度和频率。结果酸相关NCCP共39例,占NCCP的56.5%(39/69)。以第1周无症状作为抑酸治疗阳性标准,酸相关NCCP抑酸试验的敏感度和特异度分别为79.5%和83.3%,阳性预测值86.1%,阴性预测值75.8%,Youden指数0.628。结论酸相关性食管疾病是NCCP最常见病因。抑酸试验在酸相关NCCP中有较高的敏感度和特异度,是临床诊断酸相关NCCP简便而实用的方法。Objective To investigate the value of diagnostic therapy of proton pump inhibitor test in acid related non-cardiac chest pain （NCCP）.Methods Sixty-nine NCCP patients were selected from 1 113 patients who had received coronary angiography owning to chest pain,underwent reflux disease questionnaire survey,gastroscopy,24-hour esophageal pH and bile monitoring.Any of those positive were selected as treatment group,otherwise as control group.Then they were all given esomeprazole 20 mg/times,2 times a day,1 week course.The serious degree of symptoms and frequency of chest pain were recorded before and after treatment.All the scales were compared and analyzed.Results There were 39 acid related NCCP patients in 69 NCCP.Positive criteria was that chest pain disappeared at the 7th day,the sensitivity,specificity,positive predictive value,negative predictive value and Youden index were 79.5％,83.3％,86.1％,75.8％ and 0.628,respectively.Conclusion Acid related disease of esophagus is the most common cause in NCCP.PPI test is the first clinical diagnostic tool in the evaluation of NCCP.

关 键 词：非心源性胸病 胸痛 质子泵抑制剂 

分 类 号：R57[医药卫生—消化系统]