关键词: 胸痛, 急诊处理, 病因分析, 临床特点

Abstract: Objective　 To explore the clinical characteristics and pathogenesis of acute non-traumatic chest pain in different gender.Methods　From June 2013 to July 2015，384 patients admitted to the 521 Hospital of Ordnance Industry for acute non-traumatic chest pain were collected.These patients were divided into male group（206 cases）and female group（178 cases）according to gender.The clinical data of the two groups were compared，included general data，chest pain characteristics（included incentives of pain，sites of pain，nature of pain，duration of pain，with or without radiating pain or complications，etc.），the causes of chest pain（included cardiac，pulmonary，aortic dissection，gastrointestinal，shingles，or unexplained etc.），electrocardiogram（ECG），echocardiography and etc.Results　There were no statistically significant difference in history of hypertension，diabetes and hyperlipidemia between the two groups（P>0.05）.There were statistically significant difference in age，smoking history and drinking history between the two groups（P<0.05）.There were no statistically significant difference in sites of pain and with or without radiating pain between the two groups（P>0.05）.There were statistically significant difference in incentives of pain，nature of pain，duration of pain and with or without complications between the two groups（P<0.05）.The causes of chest pain in male group were cardiac 84 cases（40.78%），pulmonary 62 cases（30.10%），aortic dissection 9 cases（4.37%），gastrointestinal 37 cases（17.96%），shingles 3 cases（1.46%）and unexplained 11 cases（5.33%）.The causes in female group were cardiac 61 cases（34.27%），pulmonary 53 cases（29.78%），aortic dissection 7 cases（3.93%），gastrointestinal 20 cases（11.24%），shingles 4 cases（2.25%）and unexplained 33 cases（18.53%）.There was statistically significant difference in cause constitute of chest pain between the two groups（χ2=27.228，P<0.05）.There were no statistically significant difference in ST-T change on ECG，decreased left ventricular diastolic function，reduced left ventricular ejection fraction，the incidence of ventricular wall motion abnormalities on echocardiography（P>0.05）.The main cause of chest pain was gastrointestinal in 18-30 year-old male group（66.67%），cardiac in 31-50，51-70 and 71-82 year-old male group（37.10%，50.67% and 53.85%，respectively）.The main cause of chest pain was gastrointestinal in 18-30 year-old female group（29.41%），unexplained in 31-50 year-old female group（31.33%），cardiac in 51-70 and 71-82 year-old female group（45.10% and 51.85%）.ConclusionThe cardiac chest pain is the main cause of acute non-traumatic chest pain both in men and women.The age of male patients is older than female，and most of the male patients have a history of smoking and drinking.The prompt and accurate treatment should be performed to these patients according to the characteristics of diseases in the clinical diagnosis and therapy.

Key words: Chest pain, Emergency treatment, Cause analysis, Clinical characteristics