天津医药

• 论著 •    

不同性别非冠心病胸痛患者的临床分析

雒芳玲   

  1. 天津市塘沽区中医医院
  • 收稿日期:2011-03-25 修回日期:2011-08-30 出版日期:2012-01-15 发布日期:2012-01-15
  • 通讯作者: 雒芳玲

The clinical analysis of non-coronary artery disease patients with chest pain in the different gender

  • Received:2011-03-25 Revised:2011-08-30 Published:2012-01-15 Online:2012-01-15

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摘要： 摘要 目的：分析不同性别的非冠心病胸痛患者的临床特征、病因、用药、误诊原因及负性情绪间的差异。 方法：通过冠状动脉造影（CAG）/冠状动脉CT（CTCA）及门控心肌核素运动试验（SPECT）明确诊断为非冠心病胸痛的患者，按性别分为女性组和男性组。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：非冠心病患者141例，女性85例，男性56例。女性比男性患者误诊时间比（P＜0.05），发病年龄高（P＜0.01）；吸烟率低，胸痛伴放射性疼痛及心电图ST-T改变高（P＜0.01）。81.2%女性长期延误诊断，44.6%男性未延误诊断。胸痛病因多为功能性疾病所致,不同性别之间无统计学差异。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91.1%女性和全部男性停服药物。排除冠心病前，女性焦虑、抑郁情绪均高于常模（P≤0.01），男性只有焦虑情绪高于常模（P＜0.05）。排除冠心病后女性的焦虑、抑郁均低于常模（P<0.01）男性的抑郁情绪低于常模（P<0.01）。男性和女性患者排除冠心病后焦虑、抑郁均较前明显降低（P<0.01）。 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。高度怀疑冠心病的患者应该早做CAG/CTCA检查，避免滥用药物，降低负性情绪及经济损失。

关键词: 非冠心病, 性别差异, 临床特征, 负性情绪

Abstract: Abstract Objective: To analyze the difference of clinical features, etiology, medication, misdiagnosed, and negative emotions in the different sexual non-coronary patients with chest pain . Methods: The CAG / CTCA and SPECT examination confirm the diagnosis in patients with non-coronary chest pain,and these patients were divided into male and femal groups by sex . The two groups were Summarized and analyzed in the clinical features, misdiagnosis, etiology, drug use and mental status. Results: 141 cases patients of non-coronary heart disease patients included 85cases females and 56 cases males. The female patients were misdiagnosed for a longer time. The onsetal age of female patients were earlier than males ,and more likely associated with radiation of pain and ECG ST-T changes. The commonal cause of female patients were dued to functional diseases of social and psychological factors . (p <0.05). The mindiagnosis of female patients didn’t timely perform CAG / CTCA examination by themselves. And the male patients didn’t delay diagnosis by obeying the doctor suggestion. It was excluding coronary heart disease before that the using medication proportion of female patients was significantly higher than male patients. after excluding coronary heart disease, 91.1%women and 100% of men stopped taking drugs.The patients had particularly negative emotions by the SDS, SAS score before exclusion of coronary heart disease,and after excluding coronary heart disease,the negative emotions decreased (p <0.01),which had no significant difference between different genders. Conclusion: The clinical characteristics of non-coronary heart disease patients with chest pain is significant gender differences. The female patients are more likely long-term misdiagnosis.Once we highly suspected patients with coronary heart disease,we should make them do CAG / CTCA examination as early as possible, in order to prevent drug abuse and reduce the negative emotional and economic losses.

Key words: coronary heart disease, gender differences, clinical features, negative emotion