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目的分析雷帕霉素洗脱支架(SES)对糖尿病患者经皮冠状动脉介入治疗后的远期影响。方法采用回顾性研究方法,在1004例接受冠状动脉内支架术治疗的冠心病患者中,84例糖尿病和250例非糖尿病患者置入SES;168例糖尿病和502例非糖尿病患者置入普通支架。记录并比较一般临床资料、冠状动脉造影及冠状动脉内支架术情况、远期心脏事件发生率和1年无心脏事件生存率。结果随访期间(平均16.2个月),SES组中糖尿病亚组和非糖尿病亚组的远期心脏事件发生率为4.8%比3.6%,P=0.744;1年无心脏事件生存率为95.0%比96.7%,P=0.602,两亚组差异均无统计学意义。但BMS组中,糖尿病亚组的远期心脏事件发生率显著高于非糖尿病组(31.0%比21.7%,P=0.015);两亚组的1年无心脏事件生存率分别为74.2%比86.8%(P=0.001)。结论SES能显著改善糖尿病患者冠状动脉支架术的远期疗效,降低靶病变再狭窄和远期心脏事件的发生率,提高1年无心脏事件生存率。
Objective To analyze the long-term effect of rapamycin-eluting stent (SES) on diabetic patients after percutaneous coronary intervention. METHODS: A retrospective study was conducted in 844 diabetics and 250 nondiabetic patients with coronary artery disease in 1004 patients undergoing coronary stenting. 168 patients with diabetes and 502 non-diabetic patients underwent stent placement. Record and compare the general clinical data, coronary angiography and coronary stenting, the incidence of long-term cardiac events and 1-year cardiac event-free survival. Results During the follow-up period (mean 16.2 months), the incidence of long-term cardiac events in the SES group was 4.8% vs 3.6%, P = 0.744; the 1-year rate of no cardiac events was 95.0% 96.7%, P = 0.602, no significant difference between the two subgroups. However, in the BMS group, the incidence of long-term cardiac events was significantly higher in the diabetic subgroup than in the non-diabetic group (31.0% vs. 21.7%, P = 0.015); the one-year cardiac event-free survival rates in the subgroup were 74.2% vs. 86.8 % (P = 0.001). Conclusion SES can significantly improve the long-term efficacy of coronary stenting in patients with diabetes, reduce the incidence of target lesion restenosis and long-term cardiac events, and improve the 1-year rate of no cardiac events.