急诊老年非创伤性胸痛患者临床特征及相关影响因素分析

Clinical characteristics of non-traumatic chest pain in elderly patients in emergency departmentand analysis of related factors

目的分析急诊科收治老年非创伤性胸痛患者的临床特征,探讨其相关影响因素。方法采用回顾性研究方法,收集2018年1—12月间因非创伤性急性胸痛就诊于本院急诊科老年患者134例的临床资料,按最终诊断分为心源性胸痛组79例,非心源性胸痛55例,收集两组患者一般人口学特征、就诊时间、就诊方式、伴随症状、生命体征、既往史及个人史等临床指标进行单因素分析、Logistic回归分析其发病相关影响因素。结果单因素分析结果显示:心源性胸痛79例(59%)较非心源性胸痛55例(41%)更为常见;男性患病比例高于女性,多以急性胸痛、胸闷为主要症状;两组患者年龄、民族既往糖尿病史、高血压病史、个人史是否饮酒、伴随症状、就诊时间、就诊季节、入院体温、来院方式、血压、血氧饱和度差异对比无统计学意义(P>0.05);性别比例、是否有冠心病病史、吸烟史、入院时呼吸、心率水平、肌钙蛋白差异对比有统计学意义(P<0.05)。经Logistic多因素分析显示影响老年非创伤性胸痛患者发病的影响因素依次为性别、冠心病史、吸烟史、呼吸频率及肌钙蛋白值(OR>1,P<0.05)。结论老年非创伤性胸痛患者以心源性胸痛较为常见,男性患者居多,多于冬、春两季发病,伴随症状以急性胸痛为主;受多种因素影响,其中男性、冠心病病史、吸烟史、肌钙蛋白升高是老年患者发生非创伤性胸痛的影响因素,临床需重点关注并予以高度警惕,避免漏诊。

Objective To analyze the clinical characteristics of non-traumatic chest pain among elderly patients in emergency department,and to explore the related factors.Methods 134 elderly patients with non-traumatic acute chest pain those admitted to the emergency department of Zhongshan Hospital of Traditional Chinese medicine from January to December 2018 were selected as the study subjects,and they were divided into cardiogenic chest pain group(79 cases)and non-cardiogenic chest pain group(55 cases),the general demographic characteristics,visiting time,visiting manner,accompanying symptoms,vital signs,past history and personal history of the two groups of patients were collected for univariate analysis and Logistic regression analysis.Results Univariate analysis showed that among the patients there were 79 cases(59%)of cardiogenic chest pain and 55 cases(41%)of non-cardiogenic chest pain.Male patients were more than female patients,and the most common symptoms were acute chest pain and sense of suppression in the chest.The differences of age,nationality,history of diabetes,history of hypertension,personal history of alcohol consumption,accompanying symptoms,visiting time,visiting season,body temperature,visiting manner,blood pressure and Oxygenation between the two groupswere not statistically significant(P>0.05).There were significant differences in sex ratio,history of coronary heart disease,smoking history,breathe,heart rate and Troponin(P<0.05).The risk factors of non-traumatic chest pain in the elderly patients were sex,coronary heart disease history,smoking history,breathe frequency and Troponin value(OR>1,P<0.05).Conclusions Cardiogenic chest pain is more common in elderly patients with non-traumatic chest pain,male patients are more than female and mostly occurs in winter and spring.The symptoms are mainly acute chest pain,the occurrence of non-traumatic chest pain is affected by many factors includingmale,coronary heart disease history,smoking history,Troponin elevation,clinical staffs should focus on the influence factors of non-traumatic chest pain in elderly patients to avoid missing diagnosis.