【摘要】 目的分析冠心病合并2型糖尿病患者的冠状动脉病变和经皮冠状动脉介入治疗(PCI)操作技术特点。方法对2002年1月至12月在阜外心血管病医院连续进行的1294例择期PCI并置入支架的患者进行回顾性分析,分析临床资料、介入治疗特点以及靶病变的位置、类型、长度等特征。结果糖尿病患者占20.8%,糖尿病组肥胖、女性、高血压、血脂异常、既往PCI患者的比例均较非糖尿病组高。糖尿病组右冠状动脉、双支或三支血管病变、高危险型病变显著多于非糖尿病患者。糖尿病组的平均治疗病变数及置入支架平均数均显著多于非糖尿病组患者(分别为1.63±0.82处比1.51±0.77处,1.66±0.84个比1.51±0.81个,P均<0.05)。糖尿病组术前狭窄程度、预扩张球囊平均长度、最大直径、最大充盈压力以及最长充盈时间均值都显著大于非糖尿病组[分别为91.00%±6.62%比89.81%±6.64%,17.07±6.31mm比16.07±7.28mm,2.30±1.11mm比2.12±0.94mm,996±444kPa(即9.86±4.40atm)比914±480kPa(即9.05±4.75atm),20.94±14.69s比18.26±14.65s,P均<0.05],而所置入支架平均直径则较小(3.15±0.47mm比3.23±0.43mm,P<0.05),但其他技术特征两组间差异无统计学意义(P>0.05)。糖尿病组与非糖尿病组间的PCI操作成功率、临床成功率差异无统计学意义(P>0.05)。结论冠心病合并2型糖尿病患者冠状动脉受累范围广,高危险型病变显著多于非糖尿病患者,在有选择的病例,PCI仍是治疗合并糖尿病的冠心病患者的有效手段。更多还原

【Abstract】 Objective To analyze the operational characteristics during selective percutaneous coronary intervention(PCI)in coronary artery disease patients with type 2 diabetes mellitus.Methods From January to December 2002,a total of 1 294 patients underwent selective PCI were analyzed retrospectively.Baseline clinical,angiographic and procedural information including complications and characteristics of target lesions were recorded.Results A 20.8% of the patients were co-morbiddedwith diabetics.Diabetic patients were more often to be obese,female,hypertensive and presented with dyslipidemia and prior PCI compare with non-diabetic patients(P<0.05).Right coronary artery disease,two-and three-vessel diseases,lesions of highly risk type were more prevalent in diabetics than those in non-diabetics.Both the number of lesions treated in each patient and the number of stents implanted in each patient in the diabetic group were more than those in the non-diabetic group(1.63±0.82 lesions vs 1.51±0.77 lesions,1.66±0.84 stents vs 1.51±0.81 stents,P<0.05,respectively).The pre-PCI degree of stenosis of diabetic patients was significantly more severe than that of non-diabetic patients(91.00%±6.62% vs 89.81%±6.64%,P <0.01).The diabetic patients needed longer balloon,greater balloon diameter,higher balloon pressure and longer balloon inflation time than non-diabetic patients(17.07±6.31 mm vs 16.07±7.28 mm,2.30±1.11 mm vs 2.12±0.94 mm,996±444 kPa vs 914±480 kPa,20.94±14.69 s vs 18.26±14.65 s,respectively,P<0.05).On the other hand,diabetic patients required smaller stents in diameter than non-diabetic patients(3.15±0.47 mm vs 3.23±0.43 mm,P<0.05).The two groups were similar in other procedural characteristics.The procedural and clinical success rates showed no significant difference between two groups(P>0.05).The incidence of main adverse cardiac events in diabetic patients was 0.7%,which was similar with that of non-diabetic patients.Conclusion Diabetic patients had more advanced and extensive coronary artery disease with highly risk type than non-diabetic patients.Selected diabetics patients can achieve coronary revascularization by PCI with acceptable outcomes.更多还原