急性心肌梗死合并糖尿病患者的经皮冠状动脉介入治疗

目的:比较急性心肌梗死合并与不合并2型糖尿病患者晚期经皮冠状动脉介入(PCI)治疗的血管病变特点及对疗效的影响。方法:96例急性心肌梗死患者,分为糖尿病组24例与非糖尿病组72例。观察冠脉病变特点及随访12个月的PCI的疗效。结果:①糖尿病组患者冠脉血管多支病变、复杂病变及远端血管病变百分比明显高于非糖尿病组(P<0.05),非致死性心梗再入院率亦明显高于非糖尿病组(P<0.05)。②非糖尿病组术后12个月左室射血分数(LVEF)值较术前明显改善(P<0.05),但糖尿病组改善不明显,糖尿病组与非糖尿病组左室舒张末内径(LVDd)术前与术后12个月均无明显变化(P>0.05)。③两组手术成功率,心源性病死率无显著性差异。结论:①急性心肌梗死合并2型糖尿病患者,其冠状动脉受累范围弥漫而广泛,病变严重和复杂程度明显高于非糖尿病组,其远期获益受限;②急性心肌梗死合并糖尿病,PCI术仍是安全有效治疗方式。

Acute myocardial infarction with diabetes percutaneous coronary intervention and follow-up

Objective:Comparison of crt come of diabetic and nondiabetic patients undergoing late percutaneous coronary intervention for acute myocardial infraction. Methods:We collected our hospital from May 2005 to July 2007 by the late heart-patient medical reperfusion patients with acute myocardial infarction patients, Divided them into diabetic and non-diabetic group. Coronary artery disease characteristics and the effect of PCI were observed during the follow-up of months. Results: ① diabetic patients with multi-vessel coronary artery disease, complex disease and vascular lesions remote percentage were significantly higher than those of non-diabetic group (P<0.05), multiple lesions(P<0.001). Non-fatal myocardial infarction re-admission rate was significantly higher than non-diabetic group (P<0.05) .② non-diabetic group after 12 months (left ventricular ejection fraction)LVEF value of a significantly improved (P<0.05), But the improvement was not obvious in diabetic group, Diabetes group and non-diabetic group end-diostolic dimension of left ventricle (LVDd) of before and after 12 months no significant change (P> 0.05). ③ two surgical success rate, cardiac mortality had no significant difference. Conclusion: ① acute myocardial infarction patients with type 2 diabetes, coronary artery involvement of its diffuse and extensive, serious and complexity of the disease are significantly higher than those of non-diabetic group, limited its long-term benefit; ② acute myocardial infarction with diabetes, PCI is still a safe and effective treatment.