摘要
目的探讨冠心病合并2型糖尿病（DM）患者冠状动脉异常程度和冠状动脉内支架术后远期疗效。方法将行冠状动脉内支架术的1172例冠心病患者分为DM组（249例）和非DM组（923例）。对两组的冠状动脉病变情况及远期临床疗效进行比较。结果与非DM组比较，DM组病变数较多（P=0.046），2支（P=0.029）和3支（P=0.013）病变比例较高，弥漫病变（P=0.001）、慢性闭塞性病变（P=0.044）及重度病变（P=0.012）多见。两组临床随访率差异无统计学意义。与非DM组相比，DM组支架内再狭窄（55.96／万比35.51／万）、再次血运重建（76.18／万比51.55／万）和主要不良心血管事件（85.50／万比61.47／万）的人月发病率均明显增高（均P=0.000）。COX多因素回归分析显示，2型DM与支架内再狭窄（P=0.000）、再次血管重建（P=0.001）、主要不良心血管事件（P=0.003）密切相关，但与死亡无明显相关。结论合并2型DM的冠心病患者冠状动脉病变较重。2型DM是支架内再狭窄、再次血管重建和主要不良心血管事件的独立预测因子。
Objective To observe the angiographic characteristics and the long-term clinical outcomes following coronary stenting in non-diabetic （ non-DM ） and type 2 diabetic （ DM ） patients with coronary artery disease. Methods This cohort study enrolled 1172 consecutive patients with coronary heart disease underwent elective coronary stenting （249 type 2 DM and 923 non-DM ）. The angiographic characteristics and the long-term clinical follow-up results were compared between non-DM and DM patients. Results The follow-up period was （39.2±6.4） months （6-83 months）, follow-up rate was 90.3% in DM and 91.0% in non-DM group （P 〉0.05）. Compared with non-diabetic patients, there were significantly higher incidences of 2-vessel （P = 0. 029 ） and 3-vessel （ P = 0. 013 ） diseases of coronary artery, severe stenosis lesion（ P = 0. 012 ）, chronic total obstructive lesion（ P =0.044 ） and long lesion（ P = 0. 001 ）, in-stent restenosis （ ISR, P = 0. 000 ） and revascularization （ P = 0. 000 ） and MACE （ P = 0. 000 ） in DM patients. COX multiple factorial analysis showed that DM is independent risk factor for ISR （P = 0.000）, revascularization（P =0.001） and MACE（P=0.003）. Conclusions CHD patients with type 2 DM are associated with multi- and more severe vessel lesions. Type 2 DM is also an independent risk factor for increased ISR, revascularization and MACE post stenting.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2009年第5期402-405,共4页
Chinese Journal of Cardiology
关键词
冠状动脉疾病
糖尿病
血管成形术
经腔
经皮冠状动脉
Coronary disease
Diabetes mellitus
Angioplasty, transluminal, pereutaneous coronary
