以胸痛为主要表现的胃食管反流病36例临床分析

目的：探讨以胸痛为主要表现的胃食管反流病的病因、临床特点及诊治方法。方法：选择本院近年来诊治的36例已排除心源性及食管器质性病变,诊断为胃食管反流病的胸痛患者,予以埃索美拉唑20mg,每日两次;吗叮林10mg,每日三次治疗8周,观察其疗效并分别于2周,4周,8周记录症状缓解情况。结果：经抗反流治疗8周后,30例（83.33%）胸痛完全消失,4例（11.11%）明显缓解,2例（5.56%）无效,总有效率达94.44%。胸痛症状在治疗2周后积分下降不明显,而治疗4周,8周后显著改善,与治疗前比较有显著性差异（P〈0.01）。结论：胃食管反流病病因复杂、临床表现多样易误诊漏诊,胃镜检查结合24小时食管动态ph监测,必要时给予质子泵抑制剂试验性治疗可提高本病的确诊率。

Clinical Analysis on 36 Gastroesophageal Reflux Disease with Chest Pain as Primary Manifestation

Objective： To investigate the pathogenesis, clinical characteristics, diagnosis and treatment on gastroesophageal reflux disease （GERD） with chest pain as primary manifestation. Methods： A retrospective analysis on 36 patients with chest pain excluded of cardiac or esophageal structural disease. Results： After 8 weeks anti-reflux therapy, 30 patients （83.33 %） completely relieved, 4 patients （11.11%） significantly relieved, and only 2 patients （5.56%） were without any improvement, the total efficacy was 94.44%. Conclusion： The complicated pathogenesis and clinical manifestation of GERD can be easily misdiagnosed, whose key diagnostic procedure is neces- sary examination combined with proton pump inhibitor experimental treatment.