2型糖尿病对药物洗脱支架治疗冠状动脉无保护左主干病变疗效的影响  

The effects of diabetes mellitus on unprotected left main artery lesion after implanting drug-eluting stent

作　　者：张晓玲[1] 罗亚玮[1] 陈方[1] 张维东[1] 任学军[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科、北京市心肺血管疾病研究所,100029

出　　处：《中国医药》2011年第8期938-940,共3页China Medicine

基　　金：首都医学发展科研基金（2009-2074）

摘　　要：目的 观察2型糖尿病（DM）对药物洗脱支架治疗冠状动脉无保护左主干（ULM）病变远期临床效果.方法 分析211例行左主干经皮冠状动脉介入治疗的ULM病变冠心病患者的临床特点,按照有无2型糖尿病分为2组,DM-ULM组68例,对照组（非DM-ULM组）143例.研究糖尿病对药物洗脱支架治疗ULM病变远期不良心脑血管事件的影响.结果 DM-ULM组年龄大,男性少,高血压和脑卒中比例高,冠状动脉SYNTAX积分高,与对照组比较差异有统计学意义[（33.9 ±14.6）比（23.1±10.2）;P=0.010].采用Log-rank方法 分析,DM-ULM组与对照组药物洗脱支架治疗后主要心脑血管事件[18例（32.6%）比20例（16.7%）]、心肌梗死[9例（20.1%）比1例（0.7%）]、硬终点事件[13例（26.3%）比6例（6.5%）]发生差异有统计学意义（P＜0.05或P＜0.01）.2组靶血管再次血运重建、脑卒中、死亡、心源性死亡发生率差异无统计学意义（P＞0.05）.结论 ULM病变合并糖尿病患者危险因素多.糖尿病是药物洗脱支架治疗冠状动脉ULM病变后远期主要心脑血管事件、心肌梗死、硬终点事件的独立预测因子.Objective To observe the effects of type 2 diabetes mellitus （DM） on the long-term clinic outcomes in the unprotected left main artery（ULM） lesion patients after implanting drug-eluting stent. Methods The clinical characters of unprotected left main artery lesion patients combining type 2 diabetes mellitus were analyzed and to study the long-term clinical effects of DM on implanting drug-eluting stent in ULM lesion patients. Results Compared with none-DM group, the ULM lesion patients with DM（DM-ULM） group were older witth less male and higher rates of hypertension, stroke and SYNTAX score[（23.1 ± 10.2） vs （33.9 ± 14.6） ;P =0.010]. With Logrank analysis, compared with the control group, the DM-ULM group had higher incidence of major adverse cardiac or cerebrovascular events（MACCE） [20（16. 7%） vs 18（32.6%）], myocardial infarction （MI）[1 （0. 7%） vs 9（20.1%）] and hard end points [6（6. 5%） vs 13（26. 3%）] （P 〈0.05）. There were no differences of targetvessel revascularization, death, stroke and cardiac death（P〉 0.05） between the 2 groups. Conclusion DM is the independent predicting factor of long-term MACCE, MI and adverse clinical endpoints.

关 键 词：冠状动脉疾病 血管成形术 不良心脑血管事件 糖尿病 

分 类 号：R543.3[医药卫生—心血管疾病]