超声心动图在酒精性心肌病诊断及评价预后中的应用效果

The Application Effect of Echocardiography in the Diagnosis and Prognosis Evaluation of Alcoholic Cardiomyopathy

摘要: 目的：探讨对酒精性心肌病患者开展诊断措施时，选择超声心动图与常规心电图，分析不同诊断方式的诊断效能，并对超声心动图评价疾病预后的效果进行分析。方法：随机抽取我院收治的90例疑似酒精性心肌病患者为研究主体，研究时间控制在2022年1月~2024年1月，其均接受超声心动图与常规心电图检查，将磁共振及临床诊断结果作为“金标准”，对比不同诊断方式的诊断效能，并对超声心动图评价疾病预后的效果进行分析。结果：“金标准”诊断结果显示，阳性78例，阴性12例；其中超声心动图诊断酒精性心肌病阳性76例，阴性14例，常规心电图诊断酒精性心肌病阳性69例，阴性21例；与常规心电图对比，超声心动图诊断酒精性心肌病的准确率及敏感度更高(P < 0.05)，漏诊率显著低于常规心电图(P < 0.05)；超声心动图检查发现，大部分患者存在左室增大(67例，85.90%)、左室射血分数下降(58例，74.36%)、室壁运动减弱(45例，57.69%)的情况，也有少部分患者存在全心扩大(25例，32.05%)及室间隔增厚(13例，16.67%)的情况；对患者进行1年的随访，40例有超声报告，其中22例患者出院后未遵医嘱继续接受治疗，也未完全戒酒，心功能下降显著，其中左室内径可见增长，左室射血分数下降；另外18例患者出院后遵医嘱继续接受治疗，严格戒酒，心功能改善显著，其中左室内径可见缩小，左室射血分数提升。结论：对酒精性心肌病患者开展诊断措施时，选择超声心动图诊断价值高，为疾病后续诊治提供有价值的参考，并为疾病治疗效果及预后的评估提供参考价值。

Abstract: Objective: To explore the diagnostic measures for patients with alcoholic cardiomyopathy, selecting echocardiography and routine electrocardiogram, analyzing the diagnostic efficacy of different diagnostic methods, and analyzing the effect of echocardiography in evaluating disease prognosis. Method: A total of 90 suspected alcoholic cardiomyopathy patients admitted to our hospital were randomly selected as the research subjects. The study period was controlled from January 2022 to January 2024. All patients underwent echocardiography and routine electrocardiogram examinations, and magnetic resonance imaging and clinical diagnostic results were used as the “gold standard” to compare the diagnostic efficacy of different diagnostic methods. The effect of echocardiography in evaluating disease prognosis was analyzed. The results of the “gold standard” diagnosis showed that there were 78 positive cases and 12 negative cases; among them, 76 cases were diagnosed as positive and 14 cases were diagnosed as negative for alcoholic cardiomyopathy by echocardiography, and 69 cases were diagnosed as positive and 21 cases were diagnosed as negative for alcoholic cardiomyopathy by routine electrocardiogram; compared with conventional electrocardiogram, echocardiography has higher accuracy and sensitivity in diagnosing alcoholic cardiomyopathy (P < 0.05), and the missed diagnosis rate is significantly lower than conventional electrocardiogram (P < 0.05); echocardiography examination revealed that the majority of patients had left ventricular enlargement (67 cases, 85.90%), decreased left ventricular ejection fraction and number (58 cases, 74.36%), weakened ventricular wall motion (45 cases, 57.69%), and a small number of patients had global heart enlargement (25 cases, 32.05%) and ventricular septal thickening (13 cases, 16.67%); a one-year follow-up was conducted on the patients, with 40 cases having ultrasound reports. Among them, 22 patients did not follow the doctor’s advice to continue treatment after discharge, nor did they completely quit drinking. There was a significant decline in cardiac function, including an increase in left ventricular diameter and a decrease in left ventricular ejection fraction; in addition, 18 patients continued to receive treatment according to medical advice after discharge, strictly quit drinking, and showed significant improvement in heart function, including a reduction in left ventricular diameter and an increase in left ventricular ejection fraction. Conclusion: When conducting diagnostic measures for patients with alcoholic cardiomyopathy, choosing echocardiography has high diagnostic value, providing a valuable reference for subsequent diagnosis and treatment of the disease, and providing a reference value for evaluating the treatment effect and prognosis of the disease.