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

摘要： 目的　探讨不同性别急诊非创伤性胸痛患者的临床特点及病因。方法　选择2013年6月—2015年7月兵器工业521医院接诊的以急性非创伤性胸痛为主诉就诊的患者384例，将其按照性别分为男性组（n=206）和女性组（n=178），比较两组患者基本资料、胸痛特点（包括疼痛诱因、疼痛部位、疼痛性质、疼痛持续时间、有无放射痛或并发症等）、胸痛病因（包括心源性、肺源性、主动脉夹层、胃肠源性、带状疱疹、原因不明确等）、心电图、超声心动图等临床资料。结果　两组患者高血压病史、糖尿病病史、高血脂病史比较，差异均无统计学意义（P>0.05）；两组患者年龄、吸烟史、饮酒史比较，差异均有统计学意义（P<0.05）。两组患者疼痛部位、有无放射痛比较，差异均无统计学意义（P>0.05）；两组患者疼痛诱因、疼痛性质、疼痛持续时间、有无并发症比较，差异均有统计学意义（P<0.05）。男性组中胸痛病因分别为心源性84例（40.78%）、肺源性62例（30.10%）、主动脉夹层9例（4.37%）、胃肠源性37例（17.96%）、带状疱疹3例（1.46%）、原因不明确11例（5.33%）；女性组中胸痛病因分别为心源性61例（34.27%）、肺源性53例（29.78%）、主动脉夹层7例（3.93%）、胃肠源性20例（11.24%）、带状疱疹4例（2.25%）、原因不明确33例（18.53%）。两组患者胸痛病因构成比较，差异有统计学意义（χ2=27.228，P<0.05）。两组患者心电图ST-T改变、超声心动图中左心室舒张功能降低、左心室射血功能降低、室壁运动异常发生率比较，差异均无统计学意义（P>0.05）。男性患者18～30岁胸痛病因主要是胃肠源性（66.67%），31～50岁、51～70岁、71～82岁胸痛病因主要是心源性（分别为37.10%、50.67%、53.85%）。女性患者18～30岁胸痛病因主要是胃肠源性（29.41%），31～50岁胸痛病因主要是原因不明确（31.33%），51～70岁、71～82岁胸痛病因主要是心源性（分别为45.10%、51.85%）。结论　男、女性急诊非创伤性胸痛病因均以心源性胸痛为主，男性患者年龄大者所占比例较女性高，且多有吸烟史和饮酒史，此类患者在临床诊治过程中应根据疾病特点及时准确治疗。

关键词: 胸痛, 急诊处理, 病因分析, 临床特点