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目的评价冠心病合并2型糖尿病患者冠状动脉病变置入药物洗脱支架后的疗效。方法选择我院2004年4月至2005年8月连续接受置入药物洗脱支架(DES)或金属裸支架(BMS)治疗并且进行了冠状动脉造影随访的139例的冠心病合并2型糖尿病患者。所有患者在支架术后6个月后接受冠状动脉造影随访。结果共139例患者(男性114例,女性25例)221处病变完成随访。其中 C 型病变94处(42.5%),完全闭塞病变42处(19.0%),平均每个病变支架长度(26.53±14.72)mm,平均参考血管直径(2.80±0.43)mm。两组患者在性别比例和年龄方面差异无统计学意义。两组在冠心病的危险因素如:高血压病、高脂血症、吸烟等方面差异无统计学意义。两组病变的复杂程度基本相当。DES 组的参考血管直径比 BMS 组小[(2.71±0.41)mm 比(2.98±0.53)mm,P<0.001]。6个月后随访,DES 组的支架内再狭窄率(10.6%比38.6%,P<0.001)和病变内晚期腔径丢失[(0.24±0.56)mm 比(0.91±0.77)mm,P<0.001]明显低于 BMS 组。DES 组的靶病变血管重建率显著低于 BMS 组(8.6%比30.0%,P<0.001)。DES 组有4例晚期支架内血栓。结论本研究显示药物洗脱支架对于冠心病合并2型糖尿病患者冠状动脉病变的介入治疗有着良好的治疗效果,明显优于金属裸支架。
Objective To evaluate the efficacy of coronary stent implantation in patients with coronary artery disease and type 2 diabetes mellitus after coronary stent implantation. Methods A total of 139 patients with coronary heart disease complicated with type 2 diabetes mellitus undergoing DES or BMS and followed up by coronary angiography were selected from April 2004 to August 2005 in our hospital. . All patients underwent coronary angiography 6 months after stenting. Results A total of 139 patients (114 males and 25 females) were followed up for 221 lesions. There were 94 (42.5%) C-type lesions and 42 (19.0%) complete occlusion lesions with an average length of 26.53 ± 14.72 mm for each lesion and an average reference vessel diameter of 2.80 ± 0.43 mm. There was no significant difference in sex ratio and age between the two groups. Two groups of risk factors in coronary heart disease such as: hypertension, hyperlipidemia, smoking and other aspects no significant difference. The complexity of the two groups of lesions is basically the same. The reference vessels in the DES group were smaller than those in the BMS group (2.71 ± 0.41 mm vs 2.98 ± 0.53 mm, P <0.001). At 6 months, the in-stent restenosis rate (10.6% vs 38.6%, P <0.001) and the loss of late luminal diameter in the DES group (0.24 ± 0.56 mm vs 0.91 ± 0.77 mm, P 0.001 ] Was significantly lower than the BMS group. The target lesion revascularization rate in DES group was significantly lower than that in BMS group (8.6% vs. 30.0%, P <0.001). There were 4 patients with advanced stent thrombosis in DES group. Conclusion This study shows that the drug-eluting stent has a good therapeutic effect on interventional treatment of coronary artery disease in patients with type 2 diabetes and coronary heart disease, which is obviously superior to bare metal stent.