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目的探讨糖尿病对经皮冠状动脉介入治疗(PCI)患者长期预后的影响。方法连续入选2367例接受PCI的冠心病患者,根据有无糖尿病分为两组:糖尿病组(719例)及非糖尿病组(1648例),通过COX回归分析研究糖尿病对PCI患者长期预后的影响。结果与非糖尿病组相比,糖尿病组男性更少,甘油三酯、N端B型利钠肽原更高,高密度脂蛋白胆固醇更低,合并陈旧性心肌梗死、心功能不全、高血压、肾功能不全、脑卒中的比例更高。糖尿病组患者冠状动脉3支病变比例、慢性闭塞比例、Gensini评分更高,平均支架个数更多,平均支架长度更长。术后随访显示,两组患者的全因死亡、主要不良心血管事件、心源性死亡、非致死性心肌梗死、非计划再次血运重建均无显著差异。多因素COX回归分析显示,糖尿病与PCI患者长期预后无显著相关。结论合并糖尿病的PCI患者在临床方面存在特殊性,但长期预后并无显著不良。
Objective To investigate the effect of diabetes on the long-term prognosis of patients undergoing percutaneous coronary intervention (PCI). Methods A total of 2367 patients with coronary artery disease undergoing PCI were enrolled in this study. Patients with diabetes were divided into two groups: diabetic group (719 cases) and non-diabetic group (1648 cases). The effect of diabetes on long-term prognosis of PCI patients was studied by COX regression analysis. Results Compared with non-diabetic group, the diabetic group had fewer males, higher triglyceride and N-terminal pro-B-type natriuretic peptide, lower HDL-cholesterol, and complicated with old myocardial infarction, cardiac insufficiency, hypertension, Renal insufficiency, a higher proportion of stroke. Diabetic patients with coronary artery disease 3 ratio, chronic occlusion, Gensini score higher, the average number of stents, the average stent length longer. Postoperative follow-up showed no significant differences in all-cause, major adverse cardiac events, cardiac death, non-fatal myocardial infarction, and unplanned revascularization in both groups. Multivariate Cox regression analysis showed no significant association between diabetes and long-term prognosis of patients with PCI. Conclusion There are some clinical characteristics in patients with diabetes mellitus, but there is no significant long-term prognosis.