中国患者伴有前肠症状的胸痛诊断
Diagnosis of chest pain with foregut symptoms in Chinese patients.
作者信息
Deng Bo, Wang Ru-Wen, Jiang Yao-Guang, Tan Qun-You, Liao Xiang-Li, Zhou Jing-Hai, Zhao Yun-Ping, Gong Tai-Qian, Ma Zheng
机构信息
Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, The Third Military Medical University, Chongqing 400042, China.
出版信息
World J Gastroenterol. 2009 Feb 14;15(6):742-7. doi: 10.3748/wjg.15.742.
AIM
To evaluate the diagnosis of chest pain with foregut symptoms in Chinese patients.
METHODS
Esophageal manometric studies, 24-h introesophageal pH monitoring and 24-h electrocardiograms (Holter electrocardiography) were performed in 61 patients with chest pain.
RESULTS
Thirty-nine patients were diagnosed with non-specific esophageal motility disorders (29 patients with abnormal gastroesophageal reflux and eight patients with myocardial ischemia). Five patients had diffuse spasm of the esophagus plus abnormal gastroesophageal reflux (two patients had concomitant myocardial ischemia), and one patient was diagnosed with nutcracker esophagus.
CONCLUSION
The esophageal manometric studies, 24-h intra-esophageal pH monitoring and Holter electrocardiography are significant for the differential diagnosis of chest pain, particularly in patients with foregut symptoms. In cases of esophageal motility disorders, pathological gastroesophageal reflux may be a major cause of chest pain with non-specific esophageal motility disorders. Spasm of the esophageal smooth muscle might affect the heart-coronary smooth muscle, leading to myocardial ischemia.
目的
评估中国患者中伴有前肠症状的胸痛诊断情况。
方法
对61例胸痛患者进行食管测压研究、24小时食管内pH监测和24小时心电图（动态心电图）检查。
结果
39例患者被诊断为非特异性食管动力障碍（29例伴有胃食管反流异常，8例伴有心肌缺血）。5例患者有食管弥漫性痉挛并伴有胃食管反流异常（2例伴有心肌缺血），1例患者被诊断为胡桃夹食管。
结论
食管测压研究、24小时食管内pH监测和动态心电图对胸痛的鉴别诊断具有重要意义，尤其是对伴有前肠症状的患者。在食管动力障碍的病例中，病理性胃食管反流可能是伴有非特异性食管动力障碍的胸痛的主要原因。食管平滑肌痉挛可能会影响心脏冠状动脉平滑肌，导致心肌缺血。
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