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目的:观察冠心病三支病变合并糖尿病患者置入药物洗脱支架的安全性及近、中期疗效。方法:2003年10月～2007年10月间57例经冠状动脉造影证实为冠心病三支病变合并糖尿病的患者置入药物洗脱支架。男38例、女19例,年龄41～79岁,平均62岁,其中稳定型心绞痛17例,不稳定型心绞痛40例。糖尿病史2～12年,其中胰岛素治疗26例,采用常规经皮冠脉介入治疗。结果:全部患者支架置入成功,临床症状明显好转或消失,57例患者共治疗193处病变,置入药物洗脱支架277枚。1例(1.8%)患者术后d4支架内亚急性血栓形成。41例(71.9%)患者术后6个月行冠脉造影,3例(7.3%)患者支架内再狭窄,选择外科搭桥治疗。随访12个月,无死亡、心肌梗死等严重心脏事件发生。结论:药物洗脱支架治疗冠心病三支病变合并糖尿病患者安全有效,近、中期效果好,远期疗效有待证实。
Objective: To observe the safety, immediate and medium-term efficacy of drug-eluting stents in three patients with coronary artery disease and diabetes mellitus. Methods: From October 2003 to October 2007, 57 patients with coronary artery disease and coronary artery disease complicated with diabetes confirmed by coronary angiography were enrolled in the study. 38 males and 19 females, aged 41 to 79 years, mean 62 years, of which 17 cases of stable angina and 40 cases of unstable angina pectoris. Diabetes history of 2 to 12 years, of which 26 cases of insulin treatment, the use of conventional percutaneous coronary intervention. Results: All the patients were successfully placed in the stent and the clinical symptoms improved or disappeared. A total of 193 lesions were treated in 57 patients, and 277 drug-eluting stents were placed. Subacute thrombosis within d4 stent was performed in 1 patient (1.8%). Thirty-one patients (71.9%) underwent coronary angiography 6 months after surgery and 3 patients (7.3%) underwent stent thrombosis. Follow-up of 12 months, no deaths, myocardial infarction and other serious cardiac events. Conclusion: The drug-eluting stent is safe and effective in the treatment of three diseases of coronary heart disease with diabetes mellitus. The efficacy of near-term and mid-term is good, and long-term efficacy remains to be confirmed.