合并糖尿病患者行冠状动脉左主干病变介入治疗的疗效分析

目的探讨冠状动脉左主干病变合并糖尿病患者行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的疗效。方法回顾性分析87例(糖尿病组36例,非糖尿病组51例)冠状动脉左主干病变患者接受PCI治疗的临床资料,比较糖尿病与非糖尿病患者行冠状动脉左主干PCI治疗的方法、疗效和随访结果。结果两组基线资料比较,差异无统计学意义(P0.05)。除外糖尿病组左主干合并前降支病变的比例高于非糖尿病组外,两组病变部位及合并病变冠状动脉分支的比例比较,差异无统计学意义(P0.05)。两组支架植入成功率比较,差异无统计学意义100%(36/36)vs.98%(50/51),P0.05]。两组介入治疗的各项结果比较,差异无统计学意义(P0.05)。两组PCI治疗后1年各项冠状动脉造影及血管内超声检查结果比较,差异无统计学意义(P0.05),随访期间冠状动脉造影和血管内超声检查均未发现左主干支架内有局部血栓的影象学表现。共83例患者随访到2007年12月,临床随访率95.4%(83/87),随访时间(31.8±6.3)个月。至随访结束,2例死亡,病死率2.4%(2/83),共有7例复发心绞痛,4例经造影证实为左主干支架内再狭窄。结论合并糖尿病的左主干病变患者,在血管内超声指导下进行介入治疗可以获得与非糖尿病患者相同的治疗效果。

Effect of percutaneous coronary intervention of left main coronary artery lesion in patients with diabetes

Objectives To evaluate the effect of percutaneous coronary intervention （PCI） of left main coronary artery lesion in patients with diabetes. Methods We retrospectively analyzed the clinical data of 87 patients （36 patients in diabetes group and 51 patients in non-diabetes group） with left main coronary artery lesion who performed PCI. The methods,curative effect and follow-up results of left main coronary artery. PCI in diabetes group and non- diabetes group were compared. Results Basic data between the two groups had no significant difference （P〉0.05）. Rates of left main coronary artery lesions and complieated coronary artery branches had no significantly differences （P〉 0.05） between the 2 groups, except for rate of left main coronary artery lesions complicated with left anterior descending branches was higher in diabetes group than that in non-diabetes group （P〈0.05）. The achievement ratio of stent implantation between the 2 groups had no significant difference 100% （36/36） vs. 98% （50/51）,P〉0.05]. Every curative parameters of PCI had no significant difference between the 2 groups （P〉0.05）. One year after PCI, results of coronary arterlography and intravascular unhrasound had no significant difference between the 2 groups （P〉 0.05）, and no images of thrombus were found by arteriongraphy and intravascular unhrasound during follow-up period. Totally 83 patients were followed up till December, 2007. Rate of follow-up was 95.4% （83/87）and follow-up time was （31.8±6.3） monthes. Two died and case fatality ratio was 2.4%（2/83）,7 recurred angina,4 of them were confirmed instent restenosis of left main coronary artery by coronary arteriography. Conclusions Under the guidance of intravascular unltrasound, treatment of PCI with drug-elutting stent in left main lesions in patients with diabetes can obtain the same good results in one-year term as those without diabetes.