强化降糖治疗对急性冠状动脉综合征合并糖尿病患者经皮冠状动脉介入治疗预后的影响  

Efficacy of intensive blood glucose control in percutaneous coronary intervention patients with acute coronary syndrome complicated with diabeticsEfficacy of intensive blood glucose control in percutaneous coronary intervention patients with acute coronary syndrome complicated with diabetics

作　　者：田声放[1] 刘双梅[1] 卢才义[2] 

机构地区：[1]青岛市市立医院保健中心,山东省266011 [2]解放军总医院老年心内科

出　　处：《中国心血管病研究》2012年第3期187-190,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的评价强化降糖治疗对急性冠状动脉综合征合并糖尿病（ACS＋DM）患者冠状动脉介入治疗（PCI）的效果和预后。方法选择2005年1月至2007年6月行PCI的ACS患者278例，按是否合并糖尿病分为ACS＋DM组（91例）和非糖尿病ACS组（NDMACS组，187例），ACS＋DM组患者严格控制血糖水平，使HbAbl〈6．5％。两组均应用DES支架行PCI术治疗，ACS＋DM组和NDMACS组分别行急诊PCI术20例（22．0％）和49例（26．2％），分别行择期PCI术71例（78．0％）和138例（73．8％）。随访36-48个月，观察手术成功率，住院期间和远期心血管事件发生率。结果ACS＋DM组患者中女性比例和三支血管病变明显高于NDMACS组，差异有统计学意义（62．6％比46．0％，P〈0．05；58．2％比33．2％，P〈0．05）。ACS＋DM组和NDMACS组PCI术成功率分别为96．7％和97．3％。两组术后并发症、住院期间心血管事件发生率和随访期间心血管事件发生率比较差异无统计学意义（P〉0．05）。结论强化降糖治疗可使ACS＋DM患者PCI术后获得与NDMACS患者同样的疗效和预后。Objective To assess the effects and prognosis of intensive blood glucose control in percutaneous coronary intervention （PCI） patients with acute coronary syndrome complicated with diabetics （ACS＋DM）. Methods From 2005.1 to 2007.6, 278 patients with acute coronary syndrome （ACS） underwent PCI in our hospital were enrolled in this study. 91 patients were suffering from ACS＋DM, and 126 patients were suffering ACS without diabetes meUitus （NDMACS）. Intensive blood glucose control in PCI patients with ACS＋DM to make HbAbl 〈6.5%. They were all treated by drug elution stents. Emergency PCI were performed in 20 patients （22.0%） in ACS＋DM and 49 patients （26.2%） in NDMACS. Non-emergency PCI were performed in 71 patients （78.0%） and 138 patients （73.8%） respectively. The incidence of major adverse cardiac events（MACE） during in hospital and the follow up period were observed. Results The incidence of female patients in the ACS＋DM groups was significantly higher than that in NDMACS groups （62.6% vs 46.0%, P〈0.05）. The incidence of the patients with triple-vessels coronary disease in the ACS＋DM groups was higher than that in NDMACS groups （58.2% vs 33.2%, P〈0.05）. There was no significant difference of the rate of successful PCI between these two groups （96.7% vs 97.3%, P〉0.05）. There was no significant difference of complications（ 10.9% vs 10.7%, P〉0.05） and incidence （2.2% vs 1.6%, P〉0.05） of MACE during in-hospital1 and follow-up period between these two groups （13.2% vs 11.2%, P〉0.05）. Conclusion In the ACS＋DM patients PCI have highly success rate. PCI is safe and effective for intensive blood glucose control in patients with ACS＋DM than those in NDMACS patients.

关 键 词：冠状动脉疾病 糖尿病 血管成形术 经皮冠状动脉介入治疗 血糖 

分 类 号：R543.3[医药卫生—心血管疾病] R587.1[医药卫生—内科学]