不同再血管化治疗对冠心病伴糖尿病患者预后的影响  

The Effect of Different Revascularization Treatment on Clinical Outcomes in Patients with Coronary Artery Disease and Type 2 Diabetes

作　　者：樊少博[1] 李曦铭[2] 高铭佑[2] 赵茹[2] 肖建勇[2] 丛洪良[2] 

机构地区：[1]天津医科大学研究生院,300070 [2]天津市胸科医院心内科

出　　处：《天津医药》2012年第6期609-611,共3页Tianjin Medical Journal

基　　金：天津市卫生局重点课题(项目编号:10KG121);天津市卫生局攻关课题(项目编号:11KG121)

摘　　要：目的:探讨不同再血管化治疗方案对冠心病伴糖尿病患者预后的影响。方法:收集在我院成功接受再血管化治疗的冠心病合并糖尿病患者456例,根据其再血管化方式分为经皮冠状动脉成形术(PCI)组(n=288)和冠状动脉旁路移植术(CABG)组(n=168),依据SYNTAX评分将各组分为高、中、低分亚组进行各亚组组间比较。评价的主要终点为术后12个月的不良心血管事件(死亡、致死/非致死性心肌梗死、致死/非致死性卒中),次要终点为12个月再次血运重建。结果:术后12个月内再发心肌梗死比例PCI组高于CABG组(P<0.05),2组间总不良事件、死亡、卒中及再次血运重建的发生率差异无统计学意义(均P>0.05)。SYNTAX评分PCI组高分组不良事件发生率高于CABG组(P<0.05),而在低分亚组与中分亚组,PCI组和CABG的不良事件发生率差异无统计学意义(均P>0.05)。结论:冠心病伴糖尿病患者接受CABG治疗并不优于PCI治疗,但SYNTAX评分高分组患者接受CABG治疗可能会降低不良事件发生率。Objective： To investigate the selection of different revascularization treatment in patients with coronary ar- tery disease and type 2 diabetes. Methods： Four hundred and fifty-six patients with coronary artery disease and type 2 diabe- tes were divided into percutaneous coronary intervention（PCI） group（n=288） and coronary artery bypass grafting（CABG）group （n=168）. According to the SYNTAX score, each group was divided into high, medium and low score subgroups. The primary endpoints were major adverse cardiac events（MACE, including all-cause deaths, myocardial infarction and stroke）within 12 months, and the second endpoint was target vessel revascularization within 12 months. Results：The rate of myocardial re-in- farction was higher within 12 months in PCI group than that of CABG group（p 〈 0.05）. There were no significant differences in total adverse cardiac events, fatality and other MACE between two groups（all P 〉 0.05）. The incidence of adverse cardiac events was higher in high score-SYNTAX PCI group than that of CABG group（P 〈 0.05）, while there was no difference be- tween low score subgroup and medium score subgroup （all P 〉 0.05）. Conclusion：It could not come to the conclusion that CABG was much better than PCI in patients with coronary artery disease and type 2 diabetes, but it might have lower inci- dence of adverse cardiac events in high score-SYNTAX subgroup.

关 键 词：冠状动脉疾病 糖尿病 2型 血管成形术 经腔 经皮冠状动脉 冠状动脉旁路移植术 非体外循环 预后 随访研究 SYNTAX评分 

分 类 号：R541[医药卫生—心血管疾病]