摘要
目的探讨酒精性心肌病(alcoholic cardiomyopathy,ACM)临床特点、误诊原因及防范措施。方法回顾性分析曾误诊为扩张型心肌病(dilated cardiomyopythy,DCM)的ACM 15例的临床资料。结果 15例病程2~5(3.24±1.32)年,主要表现为慢性心功能不全,心功能Ⅱ~Ⅳ级,心脏超声检查均提示左室增大。15例既往均反复多次在外院就诊误诊为DCM,误诊时间(3.86±3.20)年。本次入院后经仔细病史询问,发现均有酗酒史。根据病史及医技检查结果确诊ACM,在原基础治疗基础上给予强制戒酒治疗,均病情好转出院。随访3个月,12例恢复良好;3例未遵循医嘱,仍饮酒,病变进展。结论 ACM属可逆性心肌病,临床表现酷似DCM,易误诊。临床上对怀疑DCM患者应注意与ACM鉴别,对确诊ACM患者及时强制性戒酒有助于改善预后。
Objective To discuss clinical characteristics, misdiagnosed causes and preventative measures of alcoholic cardiomyopathy （ACM）.Methods Clinical data of 15 patients with ACM, who were misdiagnosed as having dilated cardiomyopathy （DCM） , was retrospectively analyzed.Results In the 15 patients, course of disease was 2-5（3.24±1.32）years, and main manifestations were chronic cardiac insufficiency, grade Ⅱ-Ⅳ heart function and left ventricular augmentation by ultrasonography.The 15 patients were misdiagnosed as having DCM repeatedly for many times in other hospitals, and the misdiagnosed time was （3.86±3.20） years.After admission in our hospital, heavy drinking history was found by asking history carefully, and then the ACM was confirmed on the basis of case history and results of medical examinations.With follow-up for 3 months, 12 patients recovered well;3 patients＇＇ conditions developed because of still heavy drinking.Conclusion ACM is a reversible cardiomyopathy, and its manifestations are similar to those of DCM, and therefore it is easily misdiagnosed.Clinicians should differentiate ACM for patients suspected as having DCM, and give alcohol withdrawal forcibly in order to improve prognosis.
出处
《临床误诊误治》
2017年第8期34-35,共2页
Clinical Misdiagnosis & Mistherapy
关键词
心肌病
酒精性
误诊
心肌病
扩张型
Cardiomyopathy
alcoholic
Diagnostic errors
Cardiomyopathy
dilated
