Study On Combined Diagnosis Of Gastroesophageal Reflux Disease Related Non-Cardiac Chest Pain

Objective:To study the proportion of non cardiogenic chest pain(NCCP)in patients with coronary angiography,and non cardiogenic chest pain(NCCP)related to esophagus or gastroesophageal reflux disease.To evaluate the diagnostic effect of electronic gastroscopy,24 hour esophageal pH monitoring,symptom index,proton pump inhibitor test(PPI test)and Gerd Questionnaire(GerdQ).Methods:To study 589 patients with coronary angiography after chest pain were collected,and Gastroesophageal Reflux Disease related Non-Cardiac Chest Pain were 65(11%).The course of disease over 14 days,frequency of in the first two weeks occurred more than 2 days / week.Exclusion of cardiogenic chest pain,There were no ST-T abnormalities in the electrocardiogram,Apart from alimentary tract ulcers,Benign and malignant tumor,profess PPI 14 days ago,Childbearing women,Abstain from taking Esomeprazole,Taking aspirin within 90 days before the experiment.After questionnaire survey,gastroscopy and 24 h esophageal acid monitoring,esomeprazole was given 20 mg,2 times / day for 14 days,and the observing changes of symptoms were repeated.The survey has general clinical data,GerdQ,BMI,which causes chest pain,type of pain,and type of pain radiation,Results:65NCCP patients met(1)erosive esophagitis,pathological acid reflux,and(2)symptom index(+),and 49 patients(75%)were diagnosed as Gerd related NCCP.There were 22 people met(1)(22 / 49,45%),27 met(2)(27 / 49,55%),and both standard 15(15 / 49,30%).PPI test:PPI test(+)in Gerd related NCCP includes 37 persons(37 / 49,75%),Non-Gerd related NCCP group has 16 people,PPI(+)only 2 people(2 / 16,14%),with statistical difference(P=0.009).The sensitivity of PPI test to GERD related NCCP was 75%(37 / 49),specificity 86%(14 / 16),(+)predictive value 94%(49 / 51),and(-)predictive value 55%(22 / 41).There was no statistical difference in the characteristics of chest pain and GERDQ: the general attributes and chest pain among the groups.The experimental results showed that there was a significant difference between the esophageal resting pressure in the two groups,and the non-related GERD group was higher than that in the GERD related NCCP group.Conclusion:PPI test is a preliminary screening method for GERD related NCCP.the combined diagnosis method can improve the diagnostic rate and reduce the misdiagnosis rate.