中青年原因不明胸痛与冠心病心绞痛的临床鉴别

The clinical differention between unknown chest pain and angina pectoris in young-middle aged patients

目的 :了解中青年原因不明胸痛患者的临床特点和诊治现状。方法 :收集同期住院的中青年 (2 0～ 5 9岁 )原因不明胸痛 34例 (研究组 )和冠心病心绞痛 46例 (对照组 )患者的临床资料进行统计分析。结果 :两组患者在年龄、性别、胸痛特点 ,心理障碍发生率 ,选择心脏以外贵重仪器检查人数 ,入院、出院诊断特点等方面差异均有显著性意义 ;研究组中使用心血管药物者较多 ,其中有心理障碍者更多选择各种贵重仪器检查 ,较少使用相应治疗药物。结论 :对中青年原因不明胸痛患者 ,临床上存在识别率高而诊断率低 ,误诊率低而漏诊率高 ,有效治疗措施不足而医源性不良暗示较多的问题 。

Objective: To investigate the clinical ch a racteristics of 20~59 aged patients with chest pain of unknown course and the pr esent state of its diagnosis and therapy.Method: We collected and analyzed the clinical features o f patients with chest pain of unknown course (study group, 34 cases) and of pati ents with angina pectoris (control group, 46 cases). Result: There were significant different rates in composi tion of age and sex, clinical manifestation of chest pain due to psychosis, usi ng expensive apparatus to examine the organs besides heart as well as the first and final diagnosis between the study group and the control group. In the study group, patients were treated more with cardiovascular drugs, and among them the patients with psychgenic disorder were examined much more with expensive apparat us, but used less antipsychic drug. Conclusion: The results indicated that 20～59 aged patien ts with chest pain of unknown course are received higher rate of recognition but lower rate of diagnosis, more negligence and less error in diagnosis. and mo re bad hint but less effective treatment.