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目的观察合并2型糖尿病的老年冠心病(coronary heart disease,CHD)患者行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗的远期疗效。方法合并2型糖尿病老年冠心病患者35例(糖尿病组),未合并2型糖尿病老年冠心病患者35例(对照组),均接受PCI治疗,比较2组冠状动脉病变情况及支架置入情况;PCI术后随访12～36个月,比较2组心绞痛再发作、主要不良心血管事件(包括心源性或非心源性死亡,非致死性心肌梗死,再次靶病变血运重建)和支架内再狭窄发生率。结果糖尿病组冠状动脉病变血管支数、植入支架数较对照组多(P<0.05),置入支架直径及长度较对照组长(P<0.05,P<0.01);PCI治疗后支架内再狭窄、再次血运重建发生率高于对照组(P<0.05);2组术后主要临床心血管事件、病死率比较差异无统计学意义(P>0.05)。结论老年冠心病合并2型糖尿病患者PCI术后支架内再狭窄发生率和再次血运重建率高,严格掌握PCI术适应证、围手术期准备充分、术后处理规范可改善预后。
Objective To investigate the long-term efficacy of percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD) complicated by type 2 diabetes. Methods Thirty - five elderly patients with type 2 diabetes mellitus (DM) and 35 elderly patients without type 2 DM (control group) were enrolled in this study. The coronary lesions and stenting were compared between the two groups. The patients were followed up for 12-36 months after PCI. Angina was recurred in 2 groups. The main adverse cardiovascular events (including cardiogenic or non-cardiac death, non-fatal myocardial infarction, re-target revascularization) The incidence of restenosis. Results Compared with the control group, the number of coronary artery vessels and the number of stents implanted in the diabetic group were significantly larger than those in the control group (P <0.05, P <0.01) The incidence of stenosis and revascularization was higher than that of the control group (P <0.05). There was no significant difference in the major clinical cardiovascular events and mortality between the two groups (P> 0.05). Conclusion The incidence of in-stent restenosis and revascularization in elderly patients with type 2 diabetes mellitus and elderly patients with coronary heart disease complicated with type 2 diabetes are high. Strict indications of PCI indications are obtained during perioperative period. Postoperative management can improve prognosis.