冠心病合并2型糖尿病药物洗脱支架置入远期预后及影响因素研究  

Long-term prognosis and influencing factors of drug-eluting stent implantation in type 2 diabetes mellitus patients with coronary artery disease

作　　者：李潞[1] 赵红丽[1] 王帅[1] 李纯[1] 张晓丹[1] 谭力力[1] 王宇[1] 于淼[1] 

机构地区：[1]沈阳医学院沈洲医院心内科,沈阳110002

出　　处：《中国实用内科杂志》2010年第11期1019-1020,共2页Chinese Journal of Practical Internal Medicine

基　　金：沈阳科学技术计划项目(1081284-9-00)

摘　　要：目的观察冠心病合并2型糖尿病(DM)患者置入药物洗脱支架(DES)的远期预后及其影响因素分析。方法入选2006年3月至2009年3月沈阳医学院沈洲医院冠心病合并DM患者253例,首次冠脉介入(PCI)治疗置入DES,随访12个月以上,记录主要不良心血管事件(MACE)及支架内血栓(ST),支架内再狭窄,再发心绞痛发生情况。结果平均随访时间为(13.1±3.6)个月,42例(17.87%)发生MACE、ST及再发心绞痛,发生事件组冠心病家族史,既往急性心肌梗死者,左主干PCI,多支血管病变,CTO病变,病变数及重度病变明显多于非事件组(P<0.05);急性心肌梗死及CTO为影响远期预后的独立危险因素。结论对于冠心病合并DM患者DES可降低再狭窄率,患者远期预后与自身病情及病变有关,综合危险因素管理更为重要。Objective To study the long-term outcomes their influencing factors after drug-eluting stent （DES） implantation for coronary artery disease patients complicated with type 2 diabetes mellitus （DM）. Methods 253 coronary artery disease patients complicated with DM were enrolled, and underwent the first PCI with drug-eluting stent （DES） implantation. All patients were followed up for at least 12 months. Major adverse cardiac events （MACE） , stent thrombosis （ST） ,intrastent restenosis （ISR） and recurrent angina were recorded. Results 42 patients （ 17.87% ） experienced MACE, ST and recurrent angina. More patients from the event group had family history of coronary artery disease, personal history of myocardial infarction （ MI ） and AMI, left stem PCI, muhivessel diseases, chronic total occlusion （ CTO）, more lesions and more severe lesion than those of non-event group （ P 〈 0. 05 ）. Acute myocardial infarction and CTO were independent risk factors for long-term prognosis. Conclusion DES may reduce restenosis in coronary heart disease patients with diabetes. Integrated management of risk factors appeared important since long-term prognosis was associated with disease severity and lesions in individual patients.

关 键 词：血管成形术 经腔 经皮冠状动脉 糖尿病 预后 

分 类 号：R5[医药卫生—内科学]