PCI与冠状动脉旁路移植术对冠心病合并糖尿病患者近远期疗效及NHP评分的影响比较  

Comparison of effects of coronary artery bypass grafting and PCI on the short-term and long-term efficacy and NHP scores in patients with coronary heart disease complicated with diabetes mellitus

作　　者：高雅 汤克虎 高俊峰 王乐丰[2] Gao Ya;Tang Kehu;Gao Junfeng(Department of Cardiology,Huairou Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 101400,China)

机构地区：[1]首都医科大学附属北京朝阳医院怀柔分院心内科,北京101400 [2]首都医科大学附属北京朝阳医院心内科,北京101400

出　　处：《中华保健医学杂志》2022年第2期102-105,共4页Chinese Journal of Health Care and Medicine

基　　金：北京市医院管理局课题(XXZ0607)。

摘　　要：目的比较经皮冠状动脉介入术(PCI)与冠状动脉旁路移植术(CABG)在冠心病合并糖尿病患者中的应用效果。方法收集2018年1月~2020年7月首都医科大学附属北京朝阳医院怀柔分院收治的189例冠心病合并糖尿病患者的临床资料,依据不同的血运重建手术方式分为PCI组(94例)和CABG组(95例),比较两组术前和术后3个月心脏功能相关指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)以及血N末端B型钠尿肽原(NT-proBNP)水平]和住院时间,比较两组NYHA心功能分级改善情况;术后随访1年,使用诺丁汉健康量表(NHP)比较两组患者术前、术后的生活质量。结果治疗后,两组患者心脏功能上述指标均较治疗前明显改善,CABG组患者住院时间长于PCI组,差异有统计学意义(P<0.05);术后CABG组心绞痛发生率明显低于PCI组,差异有统计学意义(P<0.05);治疗后,两组NHP各维度评分均较治疗前改善,差异有统计学意义(P<0.05),治疗后CABG组患者躯体活动和疼痛情况得分均高于PCI组,差异有统计学意义(P<0.05)。结论CABG和PCI术近期疗效相当,均能改善患者心肌供血和心功能水平,PCI术后恢复时间较快,但从远期疗效看,CABG术后再发心绞痛和血运重建的发生率较PCI降低。Objective To compare the application effects of percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)on patients with coronary heart disease(CHD)complicated with diabetes mellitus(DM).Methods The clinical data of 189 patients with CHD complicated with DM treated in department of cardiology of the hospital were collected between January 2018 and July 2020.According to different revascularization surgery methods,the patients were divided into PCI group(n=94)and CABG group(n=95).The cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end systolic dimension(LVESD),left ventricular end diastolic dimension(LVEDD),blood N-terminal B-type natriuretic peptide(NT-proBNP)]and hospital stay were compared between the two groups before surgery and at 3 months after surgery,and the improvement status of NYHA cardiac function grading of the two groups was compared.At 1 year of follow-up after surgery.Nottingham Health Profile(NHP)was used to compared the quality of life of the two groups of patients before and after surgery.Results After treatment,the above indicators of cardiac function of the two groups of patients were significantly improved compared to before treatment,and the hospital stay of patients in CABG group was longer than that in PCI group(P<0.05).The incidence rate of angina pectoris in CABG group was significantly lower than that in PCI group(P<0.05).After treatment,the scores of dimensions of NHP in the two groups were improved compared with those before treatment(P<0.05).After treatment,the scores of physical activity and pain status of patients in CABG group were higher than those in PCI group(P<0.05).Conclusion CABG and PCI have similar short-term efficacy,and both can improve the myocardial blood supply and cardiac function of patients and have fast recovery time after PCI.However,from the perspective of long-term efficacy,the incidence rates of postoperative recurrent angina pectoris and revascularization of CABG group are lower than those of PCI

关 键 词：冠心病合并糖尿病 经皮冠脉介入治疗 冠状动脉旁路移植术 近远期疗效 

分 类 号：R541[医药卫生—心血管疾病]