糖尿病与非糖尿病患者支架植入术后支架边缘血管形态学比较  

Morphologic comparison of the vessels between diabetic patients and non-diabetes patients after percutaneous coronary intervention

作　　者：刘博[1] 张新禄[1] 侯玉清[1] 黄铮[1] 郭志刚[1] 周忠江[1] 曹世平[1] 崔凯[1] 陈海滨[1] 修建成[1] 

机构地区：[1]南方医科大学南方医院心内科

出　　处：《广东医学》2014年第7期1002-1005,共4页Guangdong Medical Journal

基　　金：广东省自然科学基金资助项目(编号:S2012010009024)

摘　　要：目的比较糖尿病(DM)患者与非DM患者支架植入术后支架边缘血管形态学情况观察结果。方法选择常规冠状动脉造影指导下行介入治疗后的100例患者进行血管内超声检查,其中DM患者35例,非DM患者65例。结果在远端参考血管段,DM患者与非DM患者相比,血管外弹力膜面积[(13.40±5.34)mm2vs(13.44±5.37)mm2]差异无统计学意义(P=0.97),DM患者远端参考血管管腔面积小于非DM患者[(7.04±2.47)mm2vs(8.67±3.76)mm2],差异有统计学意义(P<0.05),斑块负荷大于非DM患者[(43±18)%vs(32±23)%],差异有统计学意义(P<0.05);支架内远端支架面积小于非DM患者[(7.61±2.43)mm2vs(8.55±2.48)mm2,P=0.05];斑块负荷大于非DM患者[(46±7)%vs(36±15)%],差异有统计学意义(P<0.05)。支架远端斑块负荷>50%的比例,DM患者高于非DM患者(36.8%vs 22.2%),但差异无统计学意义。结论常规造影指导的DM患者介入治疗后,支架远端管腔面积小,斑块负荷重,这可能是DM患者支架远端再狭窄率高于非DM患者的原因。Objective To compare the morphology of the vessels between diabetic mellitus（ DM） patients and non-DM patients after percutaneous coronary intervention（ PCI）.Methods One hundred patients（ 35 DM and 65 non-DM） who underwent intravascular ultrasound（ IVUS） examination after angiographic-guided PCI were enrolled.Results At the distal reference segments,there was no significant difference between DM patients and non-DM patients in external elastic membrane area [（ 13.40 ± 5.34） mm2vs（ 13.44 ± 5.37） mm2,P = 0.97],but significantly smaller MLA was observed in DM patients than that of non-DM patients [（ 7.04 ± 2.47） mm2vs（ 8.67 ± 3.76） mm2,P〈0.05],with significantly larger plaque burden（ PB） in DM patients than that in non-DM patients [（ 43 ± 18） % vs（ 32 ± 23） %,P〈0.05].At distal part of the in-stent segments,smaller MSA [（ 7.61 ± 2.43） mm2vs（ 8.55 ± 2.48） mm2,P = 0.05]and larger PB [（ 46 ± 7） % vs（ 36 ± 15） %,P〈0.05]were observed in DM patients than non-DM patients.At distal stent margins,the proportion of patients with PB over 50% was higher in DM patients than non-DM patients,but with no significant difference（ 36.8% vs 22.2%,P〈0.05）.Conclusion After angiographic-guided PCI,smaller MLA and bigger PB at distal stent margins may relate to the high risk of distal edge restenosis in DM patients.

关 键 词：支架边缘再狭窄 糖尿病 血管内超声 

分 类 号：R322.123[医药卫生—人体解剖和组织胚胎学]