冠状动脉旁路移植术后糖尿病患者预后的临床研究
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2010年第4期
- 页码:
- 560-562,568
- 栏目:
- 临床研究
- 出版日期:
- 2010-06-10
文章信息/Info
- Title:
- Clinical study of patients with diabetes mellitus after coronary artery bypass grafting
- Author(s):
- WU Chang-yan; CHEN Fang; ZHANG Wei-dong; LI Hai-yan; GAO Yue-chun; ZHANG Xiao-ling
- Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的: 探讨冠状动脉旁路移植术（CABG）术后复发心绞痛的糖尿病患者临床资料和冠状动脉特征。方法: 回顾性分析2006～2008年247例CABG术后复发心绞痛接受PCI治疗的临床资料，以是否患糖尿病分组。结果: 糖尿病患者术后心绞痛复发率高 。餐后血糖及糖化血红蛋白（HbAlc）两组间有显著差异（P<0.05）。冠脉造影糖尿病组在自身血管病变，PCI支架类型有显著差异（P<0.05）。远期心肌梗死糖尿病组（12%）高于非糖尿病组（5%）(P<0.05)。血运重建糖尿病组（22%），非糖尿病组（15%），有显著差异（P<0.05）。结论: 糖尿病患者CABG术后心绞痛复发率高，病变复杂，远期并发症发生率高，预后差。
- Abstract:
- AIM: To study the clinical characteristics and pathological changes in coronary artery in patients with recurrent myocardial ischemia after coronary artery bypass grafting (CABG). METHODS: Data were retrospectively reviewed in 247 patients who had recurrent myocardial ischemia after CABG and underwent percutaneous coronary intervention (PCI). Patients were divided into two groups: diabetes mellitus (DM) group and non-DM groups. RESULTS: The ratio of recurrent myocardial ischemia was higher and PBG and HbAl were significantly higher in DM group (P<0.05). A significant difference was observed in blood vessel changes and types of PCI stent (P<0.05). Long-term ratio of the AMI was higher in DM group (11.9%) compared with that in non-DM group (5.1%) (P<0.05) and the revascularization rate was also higher in DM group (22.4%) than the rate (15.3%) in non-DM group (P<0.05). CONCLUSION: Recurrent myocardial ischemia after CABG is high in patients with diabetes mellitus along with severe coronary vessel involvement and complications.
参考文献/References
［1］Bartnik M, Rydén L, Ferrari R, et al. The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart［J］. Eur Heart J, 2004, 25(21):1880-1890.［2］Dzavik V, Yee KM, Anderson T, et al. Outcome of PTCA and stenting in diabetic and nodiabetic patients:a report from the total occlusion stidy of Canada (TOSCA) investigators［J］. J am coll Cardiol, 2002, 39(3):28.
［3］李小鹰. 糖尿病合并冠心病的病理基础于临床特点［J］. 中华老年多器官疾病杂志, 2004, 3(1):8-10.
［4］Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies［J］. BMJ, 2006, 332(7533):73-78.
［5］ Chiasson JL, Gomis R, Hanefeld M, et al. The STOP-NIDDM Trial:an international study on the efficacy of an alpha-glucosidase inhibitor to prevent type 2 diabets in a population with glucose tolerance, rationale, design, and Preliminary scieening data Study to Prevent Non-Insulin-Dependent Diabetes Mellitus［J］. Diadetes Care, 1998, 21(10):1720-1725.
［6］Goldman S, Zadian K, Moritz T, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative study［J］. J Am Coll Cardiol, 2004, 44(11）:2149-2156.
［7］Sabik JF 3rd, Blackstone EH, Gillinov AM, et al. Occurrence and risk factors for reintervention after coronary artery bypass grafting［J］. Circulation, 2006, 114(1 Suppl):1454-1460.
备注/Memo
- 备注/Memo:
- 收稿日期：2009-06-11.作者简介：吴长燕，主治医师Email:changyanwu@yahoo.com.cn
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