冠状动脉旁路移植术后糖尿病患者预后的临床研究

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(P0.05)。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(P0.05)。远期心肌梗死糖尿病组(12%)高于非糖尿病组(5%)(P0.05)。血运重建糖尿病组(22%),非糖尿病组(15%),有显著差异(P0.05)。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。

Clinical study of patients with diabetes mellitus after coronary artery bypass grafting

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.