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目的:比较临床实践中血管重建术式对糖尿病并多支冠状动脉病变患者临床结果的影响。方法:2006年6月～2010年3月,确诊为糖尿病并发多支冠脉病变的冠心病患者226例,非随机行冠状动脉介入治疗(支架术,PCI)和冠脉搭桥术(CABG)对照研究。分析患者随访1年的临床结果。结果:CABG组和PCI组分别入选患者为105例和121例。比较CABG组与PCI组患者的年龄[(63±6)岁vs.(68±7)岁,P<0.05]和高血压病史(97.1%vs.89.3%,P<0.05)均有显著性差异,其他的临床特性均无显著性差异。随访1年的临床结果显示,CABG组与PCI组比较再次血管重建(TVR)(1.0%vs.18.2%,P<0.01)和主要心脑血管事件(MACCE)(14.3%vs.28.1%,P<0.01)均有显著性差异;而比较非致死性心肌梗死,卒中和死亡则无显著性差异。结论:糖尿病并多支病冠脉变的冠心病患者血管重建时CABG优于PCI。
OBJECTIVE: To compare the clinical effects of revascularization in clinical practice on patients with diabetes and multiple coronary lesions. Methods: From June 2006 to March 2010, 226 patients with coronary artery disease diagnosed as diabetic complicated with multiple branches of coronary artery disease were enrolled in this study. Non-randomized coronary intervention (PCI) and coronary artery bypass graft (CABG) the study. Analysis of 1 year follow-up of patients with clinical results. Results: There were 105 cases and 121 cases in the CABG group and PCI group respectively. There were significant differences between the CABG group and the PCI group in age [(63 ± 6) vs. (68 ± 7) years, P <0.05] and history of hypertension (97.1% vs.89.3%, P <0.05) , No other clinical features were significantly different. The follow-up of one year of follow-up showed that in the CABG group compared with the PCI group, the rates of TVR (1.0% vs.18.2%, P <0.01) and MACCE (14.3% vs.28.1%, P <0.01). However, there was no significant difference between non-fatal myocardial infarction, stroke and death. Conclusion: CABG is superior to PCI in revascularization of patients with coronary artery disease and diabetes.