糖尿病对经皮冠状动脉介入治疗患者长期预后的影响
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(中国医科大学附属盛京医院心内科,辽宁省沈阳市 110004)

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王卓,在读硕士研究生,研究方向为冠心病,E-mail为wang1314zhuo@163.com。

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辽宁省科技厅社会发展攻关计划(2011225020)


The Influence of Diabetes on Long-term Prognosis in Patients Treated by Primary Percutaneous Coronary Intervention
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Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China)

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    摘要:

    目的 探讨糖尿病对经皮冠状动脉介入治疗(PCI)患者长期预后的影响。方法 连续入选2367例接受PCI的冠心病患者,根据有无糖尿病分为两组:糖尿病组(719例)及非糖尿病组(1648例),通过COX回归分析研究糖尿病对PCI患者长期预后的影响。结果 与非糖尿病组相比,糖尿病组男性更少,甘油三酯、N端B型利钠肽原更高,高密度脂蛋白胆固醇更低,合并陈旧性心肌梗死、心功能不全、高血压、肾功能不全、脑卒中的比例更高。糖尿病组患者冠状动脉3支病变比例、慢性闭塞比例、Gensini评分更高,平均支架个数更多,平均支架长度更长。术后随访显示,两组患者的全因死亡、主要不良心血管事件、心源性死亡、非致死性心肌梗死、非计划再次血运重建均无显著差异。多因素COX回归分析显示,糖尿病与PCI患者长期预后无显著相关。结论 合并糖尿病的PCI患者在临床方面存在特殊性,但长期预后并无显著不良。

    Abstract:

    Aim To investigate the influence of diabetes on the long-term prognosis in patients with coronary heart disease (CHD) treated by percutaneous coronary intervention (PCI). Methods A total of 2367 consecutive patients with CHD treated by PCI were selected. According to whether there was diabetes, the patients were divided into two groups:diabetes group (n=719) and non-diabetes group (n=1648). The influence of diabetes on the long-term prognosis of patients with CHD after PCI was studied by the COX regression analysis. Results Compared with the non-diabetes group, the rate of male patients and level of high density lipoprotein cholesterol (HDLC) were lower, the levels of triglyceride and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were higher, the proportions of old myocardial infarction (OMI), cardiac dysfunction, hypertension, renal dysfunction and cerebral apoplexy were higher in the diabetes group. The proportion of coronary three-vessel lesion, chronic occlusion ratio and Gensini score were higher, average number of stents was more and the average length of stent was longer in the diabetes group. Postoperative follow-up showed that there was no significant difference on all-cause mortality, major adverse cardiovascular event (MACE), cardiac death, nonfatal myocardial infarction and unplanned repeat revascularization between the two groups. Multivariate COX regression analysis showed that there was no significant correlation between diabetes and long-term prognosis of patients with PCI. Conclusions PCI patients with diabetes have special clinical characteristics, but the long-term prognosis is not significantly adverse.

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王卓,于彤彤,董媛媛,宋娇磊,李影,陈子涵,王传合,韩苏,孙志军,孙兆青.糖尿病对经皮冠状动脉介入治疗患者长期预后的影响[J].中国动脉硬化杂志,2016,24(7):679~682.

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  • 收稿日期:2015-10-12
  • 最后修改日期:2015-12-31
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  • 在线发布日期: 2016-07-05