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目的:研究经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗合并冠状动脉左主干病变糖尿病患者的临床特征及预后。方法:回顾性分析首次冠脉造影并提示冠状动脉左主干病变接受PCI治疗患者共2350人,其中2型糖尿病患者692人,非糖尿病患者1658人。比较两组患者的基本临床特征、冠脉造影及介入特点、随访结果等。结果:基线资料中糖尿病组患者的高血压比例、高血脂比例、脑血管病比例、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)与血肌酐(creatinine,Crea)值明显高于非糖尿病组,在造影及PCI资料中糖尿病患者左主干体部病变和全程病变明显高于非糖尿病患者,左主干病变完全血运重建率以及药物洗脱支架(Drug eluting stent,DES)使用率明显低于非糖尿病组。糖尿病组患者主要心血管不良事件(Major adverse cardiac events,MACE)发生率和全因死亡显著增高(13%vs 10%,P<0.05;7.7%vs 5.5%,P<0.05)。结论:PCI治疗合并糖尿病冠状动脉左主干病变患者存在可能的临床不良事件率增加的风险。
Objective: To study the clinical characteristics and prognosis of percutaneous coronary intervention (PCI) in the treatment of diabetic left main coronary artery disease with diabetes. Methods: A retrospective analysis of the first coronary angiography and prompted the left main coronary artery disease received PCI treatment of a total of 2350 patients, of which 692 were type 2 diabetes, 1658 non-diabetic patients. The basic clinical features, coronary angiography, interventional characteristics and follow-up results of the two groups were compared. Results: In the baseline data, the proportion of hypertension, hyperlipidemia, the proportion of cerebrovascular disease, high-density lipoprotein cholesterol (HDL-C) and creatinine (Crea) in diabetic patients were significantly higher than those in diabetic patients In the non-diabetic group, the lesions and pathological changes of the left main trunk of patients with diabetes mellitus and PCI were significantly higher than those of non-diabetic patients in the contrast and PCI data. The rate of complete revascularization in the left main trunk and the drug eluting stent (DES) Lower than non-diabetic group. The incidence of major adverse cardiac events (MACE) and all-cause mortality in diabetic patients were significantly higher (13% vs 10%, P <0.05; 7.7% vs 5.5%, P <0.05). Conclusions: There is a potential risk of an increased rate of clinical adverse events in PCI in patients with left main coronary artery disease and diabetes mellitus.