戒烟对糖尿病合并冠心病患者冠脉支架植入术后预后的影响

目的观察2型糖尿病合并冠心病患者行冠脉成形及支架植入术后是否戒烟对支架内再狭窄及预后的影响。方法观察2001年5月至2003年5月我院收治的糖尿病合并冠心病同时吸烟的患者行冠脉成形及支架植入术后的患者,共179例按术后是否完全戒烟分为戒烟组共106人;非戒烟组73例。术后常规随访6个月,观察指标包括死亡等心血管事件等,6个月后行活动平板检查,结果阳性的行再次选择性冠脉造影。如因各种原因不能行活动平板检查,直接行冠脉造影。结果随访期间无死亡病例,非戒烟组23例(21.7%)冠脉造影证实支架内再狭窄,而戒烟组仅14例(13.6%)冠脉造影证实支架内再狭窄。两组再狭窄例数比差异有显著性(P=0.004)。结论2型糖尿病合并冠心病行冠脉成形及支架植入术患者,如术前有吸烟史,术后戒烟能有效减少此类患者的支架内再狭窄。

Effects of smoking cessation after percutaneous coronary intervention in patients with type 2 diabetes

ObjectiveTo investigate the prognostic effects and in-stent restenosis of smoking cessation after percutaneous coronary intervention(PCI) in type 2 diabetes mellitus patients with coronary heart disease(CAD). MethodsA total of 179 patients with type 2 diabetes who underwent PCI in our hospital and follow up routinely have been studied. According to whether they stop smoking or not after PCI, all patients were classified into smoking cessation group and control group. All the patients accepted follow-up at least 6 months after the procedure.The end point included death, revascularization and so on. After 6-month follow-up, the treasmill exercise would be done. In the case of a positive treasmill result,the selective angiography would be done. ResultsThere was no dead case and acute myocardial infarction within the period of follow-up. There were 23 cases(21.7%) with in-stent restenosis in control group, but just 14 cases(13.6%) with in-stent restenosis in the smoking cessation group.There was significant difference in two groups(P=0.004). ConclusionFor the type 2 diabetes mellitus with CAD and smoking patients, it would never be too late to stop smoking after PCI. It can reduce the in-stent restenosis efficiently after the procedure of PCI.