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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2012年第2期

页码:

236-239

栏目:

临床研究

出版日期:

2012-04-25

文章信息/Info

Title:

Comparison of two revascularization strategies for diabetic patients with multivessel disease

作者:

杨立华¹; John K. French²

(1.广西贵港市中医医院心内科，广西 贵港 537100；2.澳大利亚新南威尔大学附属利物浦医院心脏中心,澳大利亚 2170)

Author(s):

YANG Li-hua¹;  John K. French²

(1.Department of Cardiology, Hospital of Traditional Chinese Medicine, Guigang 537100, Guangxi, China; 2.Center of Cardiology, Affiliated Liverpool Hospital, University of New South Wales, Australia 2170)

关键词:

冠状动脉旁路移植术; 经皮冠状动脉介入术; 糖尿病

Keywords:

coronary artery bypass grafting;  percutaneous coronary intervention;  diabetes

分类号:

R543.3

DOI:

-

文献标识码:

A

摘要:

目的:比较临床实践中血管重建术式对糖尿病并多支冠状动脉病变患者临床结果的影响。方法：2006年6月~2010年3月，确诊为糖尿病并发多支冠脉病变的冠心病患者226例，非随机行冠状动脉介入治疗（支架术，PCI)和冠脉搭桥术(CABG)对照研究。分析患者随访1年的临床结果。结果：CABG组和PCI组分别入选患者为105例和121例。比较CABG组与PCI组患者的年龄［(63±6)岁 vs.(68±7)岁，P<0.05］和高血压病史(97.1% vs. 89.3%,P<0.05)均有显著性差异，其他的临床特性均无显著性差异。随访1年的临床结果显示，CABG组与PCI组比较再次血管重建（TVR）(1.0% vs. 18.2%，P<0.01)和主要心脑血管事件（MACCE）(14.3% vs. 28.1%，P<0.01)均有显著性差异；而比较非致死性心肌梗死，卒中和死亡则无显著性差异。结论：糖尿病并多支病冠脉变的冠心病患者血管重建时CABG优于PCI。

Abstract:

AIM:To compare the outcome of coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in diabetic patients with multivessel disease (MVD). METHODS: Two hundred and twenty-six diabetic patients with multivessel disease, clinically confirmed from June 2006 to March 2010, nonrandomly underwent CABG (n=105) or PCI (n=121). Clinical outcomes of the 1-year follow-up were compared. RESULTS: The number of older patients in the PCI group was higher than in the CABG group ［(63±6)years vs. (68±7)years, P<0.05］, but the number of hypertensive patients in the CABG group was higher than that in the PCI group (97.1% vs. 89.3%, P<0.05). No significant differences were observed in other baseline characteristics between groups. The 1-year follow-up showed a significant decrease of major adverse cardiac or cerebrovascular event (MACCE) in CABG group compared with that in the PCI group (14.3% vs. 28.1%, P<0.01). Additionally, the rate of target vessel revascularization (TVR) in the CABG group was much lower than in the PCI group (1.0% vs. 18.2%, P<0.01). No significant differences were observed in mortality, myocardial infarction and stroke between groups. CONCLUSION: Coronary artery bypass grafting is superior for diabetic patients with multivessel disease.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2011-10-18.作者简介：杨立华，副主任医师，硕士 Email:ylh9188@126.com

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更新日期/Last Update: 2012-04-01