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目的探讨以胸痛为主诉哮喘患者的临床特点、血嗜酸性粒细胞(Eos)、嗜酸性粒细胞阳离子蛋白(ECP)水平及其诊断、鉴别诊断、治疗、发病机制等。方法收集2010年11月~2014年8月内蒙古医科大学附属医院呼吸科以胸痛为主诉的患者378例,参照咳嗽变异性哮喘的诊断标准,73例被诊断为哮喘,同期收集典型哮喘患者30例,健康对照32例,对其进行血Eos、ECP的测定。分析以胸痛为主诉哮喘患者的性别、年龄、过敏史、临床症状等临床特点,讨论以胸痛为主诉哮喘患者的诊断、鉴别诊断、治疗、发病机制等。结果 73例以胸痛为主诉哮喘患者中有过敏史者37例(50.68%),与典型哮喘患者及正常对照组相比,性别、年龄、过敏史无显著差异(P>0.05),血中Eos及ECP的水平均与典型哮喘组无显著差异(P>0.05),但其与典型哮喘组均明显高于正常对照组(P<0.05),在确诊前曾被误诊者18例(24.66%),按哮喘治疗方案治疗有效。结论以胸痛为主诉就诊于呼吸科的患者哮喘发病率较高,与典型哮喘有相似的发病机制及治疗效果,其诊断可参考咳嗽变异性哮喘的诊断标准,加强对此类患者的认识,避免误诊误治,从而改善患者预后,提高患者生活质量,避免资源浪费。
Objective To investigate the clinical features of patients with asthma on chest pain, the levels of blood eosinophils (Eos), eosinophil cationic protein (ECP) and their diagnosis, diagnosis, treatment, pathogenesis and so on. Methods A total of 378 patients with chest pain were recruited from Department of Respiratory Medicine, Inner Mongolia Medical University Affiliated Hospital from November 2010 to August 2014. According to the diagnostic criteria of cough variant asthma, 73 cases were diagnosed as asthma. Thirty patients with typical asthma were collected in the same period. , 32 healthy controls, their blood Eos, ECP determination. To analyze the clinical features of patients with asthma, such as sex, age, history of allergy and clinical symptoms, and to discuss the diagnosis, differential diagnosis, treatment and pathogenesis of patients with chest pain as the main complaint. Results There were 37 cases (50.68%) with history of allergy in patients with chest pain and asthma. There was no significant difference in gender, age and allergy between the patients with asthma and normal controls (P> 0.05) (P <0.05). However, they were significantly higher than those in the normal asthma group (P <0.05), and 18 cases (24.66%) were misdiagnosed before the diagnosis. , According to the treatment of asthma treatment effective. Conclusions The patients with respiratory complaints who suffer from chest pain are more likely to have asthma, and have similar pathogenesis and treatment effects to those with typical asthma. The diagnosis can be based on the diagnostic criteria of cough variant asthma to enhance the understanding of such patients and avoid Misdiagnosis and mistreatment, thereby improving patient prognosis, improve patient quality of life, to avoid waste of resources.