2型糖尿病合并冠状动脉三支病变患者的临床特点及介入治疗远期预后

发布时间：2018-08-30 12:03

【摘要】：目的分析2型糖尿病(T2DM)合并冠状动脉三支病变患者的临床特点及其冠脉介入治疗(PCI)的远期预后。方法选择908例冠脉造影为三支病变PCI的患者,分为T2DM组274例,非T2DM组634例,记录既往病史,通过电话及门诊长期随访患者术后用药情况及主要不良心血管事件发生情况,平均随访(39.7±16.7)个月。结果 T2DM组中女性多(38%vs 26.8%,P=0.001),体重指数(BMI)高[(26.23±3.3)vs(25.71±3.0)kg/m2,P=0.02],高脂血症(40.5%vs 29.7%,P=0.001),非ST段抬高型急性心肌梗死(NSTEAMI,5.5%vs 2.7%,P=0.036)的发生率高于非T2DM组,ST段抬高性急性心肌梗死(STEAMI)发生率低于非T2DM组(19.3%vs 26.7%,P=0.019)。T2DM组再次血运重建发生率(21.5%vs13.4%,P=0.002)高于非T2DM组。结论 T2DM合并冠脉三支病变患者中女性居多,且存在多种代谢紊乱,NSTEAMI发生率高,STEAMI发生率低。此类患者远期预后相对理想,但再次血运重建率高,需根据综合因素选择治疗策略,并强化冠心病二级预防治疗。
[Abstract]:Objective to analyze the clinical features of type 2 diabetes mellitus (T2DM) with coronary artery disease and the long term prognosis of coronary intervention therapy (PCI). Methods 908 patients with PCI were divided into T2DM group (n = 274) and non-T2DM group (n = 634). The mean follow-up was (39.7 卤16.7) months. Results in the T2DM group, there were more women (38%vs 26.8i), higher body mass index (BMI) [(26.23 卤3.3) vs (25.71 卤3.0) kg/m2,P=0.02], 40.5%vs 29.775% (P < 0.001), and higher incidence of (STEAMI) in the non-T2DM group than in the non-T2DM group (19.3%vs 26.719) .T2DM group. The incidence of re-revascularization (21. 5 vs 13. 4) was higher than that of non-T2DM group. Conclusion female patients with T2DM complicated with coronary artery disease are mostly female, and the incidence of NSTEAMI is high and the incidence of STEAMI is low. The long-term prognosis of this kind of patients is relatively ideal, but the rate of re-revascularization is high. It is necessary to select the treatment strategy according to the comprehensive factors and strengthen the secondary preventive therapy of coronary heart disease.
【作者单位】：天津泰达国际心血管病医院心内五科;
【分类号】：R541.4;R587.1

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