冠状动脉慢性闭塞性病变合并2型糖尿病患者临床特点及介入术后的预后研究  

Clinical Features and Postoperative Prognosis of T2DM Combined with Chronic Total Occlusion

作　　者：武刚[1] 程璐[1] 谢玉霞[1] 

机构地区：[1]新疆医科大学附属中医医院心内二科,新疆乌鲁木齐市830000

出　　处：《中国全科医学》2013年第11期1240-1243,共4页Chinese General Practice

摘　　要：目的探讨冠状动脉慢性闭塞性病变合并2型糖尿病患者的临床特点及经皮冠状动脉介入治疗(PCI)的预后。方法选择2009年278例冠心病行PCI患者,分为冠状动脉慢性闭塞性病变合并2型糖尿病组(CTO-DM组)137例和单纯冠状动脉闭塞病变组(单纯CTO组)141例,对比分析两组患者的临床特点及PCI后随访结果。结果 CTO-DM组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)〔Lp(a)〕水平高于单纯CTO组,高密度脂蛋白胆固醇(HDL-C)水平低于单纯CTO组,差异有统计学意义(P<0.05)。两组冠状动脉病变支数分布间差异有统计学意义(P<0.05),病变血管分布间差异无统计学意义(P>0.05)。术后随访7～18个月,在随访期内两组患者分别复查冠状动脉造影术,结果显示两组术后支架内再狭窄(ISR)率、血管内再狭窄部位再次血运重建率间差异均有统计学意义(P<0.05)。结论冠状动脉CTO-DM与单纯CTO患者的临床资料、冠状动脉病变、介入术后预后有显著差异,前者血管病变程度重,且PCI后远期预后相对理想,但ISR率和再次血运重建率高。Objective To study the clinical features of chronic total occlusion （CTO） combined with type II diabetes mellitus （T2DM） and its postoperative prognosis, nethords A total of 278 patients in 2009 with coronary heart disease who had selective coronary stenting were divided into groups CTO - DM （n = 137, with CTO combined with T2DM）, CTO （n = 141, with only CTO）. The clinical features of coronary artery and follow -up results after operation were analyzed comparatively. Results The levels of total cholesterol （ TC）, triacylglycerol （ TG）, low density lipoprotein cholesterol （ LDL - C）, lipoprotein （a） were higher, high density lipoprotein cholesterol （HDL- C） lower in CTO -DM group than in CTO group, the difference was significant （ P 〈 0.05 ）. There was difference in distribution of coronary artery lesion number between 2 groups （ P 〈 0.05 ）, but there was not in distribution of lesion arteries （P 〉 0. 05）. Postoperative follow - up lasted 7 - 18 months. Coronary angiog-raphy was done to see the condition of arteries and stent. There was significant difference in in - stent restenosis （ISR） rates and revascularization rate of vascular restenosis site between 2 groups （P 〈 0. 05 ）. ConclusionThe clinical data, coronary artery lesion and postoperative prognosis of CTO - DM are significantly different from those of simple CTO. The former has severer lesions and better postoperative long - term prognosis, but higher rates of ISR and revascularization.

关 键 词：动脉闭塞性疾病 冠状动脉 糖尿病 支架 预后 

分 类 号：R541.1[医药卫生—心血管疾病]