比较药物洗脱支架和普通支架治疗冠心病合并2型糖尿病的疗效

目的评价药物洗脱支架治疗冠心病合并2型糖尿病的疗效。方法药物洗脱支架组为2002年12月～2004年11月,冠心病合并2型糖尿病患者68例,因冠状动脉内原发病变接受药物洗脱支架置入;对照组为我科经皮冠状动脉介入术资料库中抽取自2001年3月以来冠心病合并2型糖尿病56例,因原发病变置入普通支架。结果术后1年内随访结果,药物洗脱支架组与普通支架组手术成功率相似(分别为97.1%与98.2%,P=1.00);累计1年内发生主要不良心脏事件率分别为19.1%与35.7%(P=0.037,比数比为0.425,95%置信限为0.188～0.961),再次血运重建分别为10.3%与25.0%(P=0.03,比数比0.344,95%置信限0.128～0.925),发生死亡、急性心肌梗死两组无差异。结论冠心病合并2型糖尿病患者常规置入药物洗脱支架安全有效,与普通支架相比,能显著降低1年主要不良心脏事件发生率。

The efficacy of sirolimus-eluting stents versus bare metal stents for typy 2 diabetes undergoing elective percutaneous coronary intervention

Objectives To evaluate the clinical outcomes of sirolimus-eluting stents (SES) patients with coronary artery disease and type 2 diabetes who underwent elective percutaneous coronary intervention. Methods From December 2002, a policy of routine SES implantation has been instituted in our hospital. During 2 year of enrollment, a total of 68 consecutive diabetic patients with the novo coronary lesions were electively treated with SES(SES group). A similar group for comparison comprised 56 consecutive patients treated with bare metal stents in the preceding period (BS group). Results After 1-year follow-up, the cumulative rate of major adverse cardiac events (death, myocardial infarction, and any repeat revascularization) was 19.1% in the SES group versus 35.7% in the BS group (P=0.037,OR=0.425 95% CI 0.188-0.961), mainly due to a marked reduction in the need for repeat revascularization 10.3% versus 25.0%(P=0.03 OR=0.344 95% CI 0.128-0.925). Conclusions Routine utilization of SES for diabetic patients significantly reduces the rate of adverse cardiac events at 1 year compared to bare metal.