中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
12期
1093-1096
,共4页
裴汉军%吴永健%杨跃进%陈纪林%乔树宾%徐波%李建军%陈珏%宋光远%赵振艳%王喜梅%高润霖
裴漢軍%吳永健%楊躍進%陳紀林%喬樹賓%徐波%李建軍%陳玨%宋光遠%趙振豔%王喜梅%高潤霖
배한군%오영건%양약진%진기림%교수빈%서파%리건군%진각%송광원%조진염%왕희매%고윤림
动脉硬化%闭塞性%糖尿病%支架
動脈硬化%閉塞性%糖尿病%支架
동맥경화%폐새성%당뇨병%지가
Arteriosclerosis obliterans%Diabetes mellitus%Stents
目的 评价糖尿病合并冠状动脉慢性完全闭塞性(CTO)病变患者置入药物洗脱支架(DES)的远期临床预后.方法 回顾性分析143例于2006年1月至2007年5月期间连续入院接受经皮冠状动脉介入治疗并置入DES的糖尿病合并CTO病变患者的临床资料,并对患者进行随访.研究终点为主要不良心血管事件,包括死亡、心肌梗死和再次靶病变血管重建.根据随访结果,将患者分为事件组和非事件组.结果 143例患者中,139例完成随访,4例失访,随访(19.8±5.1)个月.长期随访中共发生主要不良心血管事件15例(10.5%),其中死亡3例,心肌梗死1例,再次靶病变血管重建11例.与非事件组比较,事件组的残余狭窄较重[(17.7±1.8)%比(15.4±5.0)%,P=0.001],最终最小管腔直径较小[(2.14±0.22)%比(2.89±0.37)%,P=0.004].Cox回归分析显示,最终最小管腔直径(OR:0.097,95%可信区间:0.013~0.694,P=0.020)为长期随访预后惟一独立危险因素.结论 糖尿病合并CTO患者置人DES安全、有效.最终最小管腔直径可能为长期随访事件的重要预测因子.
目的 評價糖尿病閤併冠狀動脈慢性完全閉塞性(CTO)病變患者置入藥物洗脫支架(DES)的遠期臨床預後.方法 迴顧性分析143例于2006年1月至2007年5月期間連續入院接受經皮冠狀動脈介入治療併置入DES的糖尿病閤併CTO病變患者的臨床資料,併對患者進行隨訪.研究終點為主要不良心血管事件,包括死亡、心肌梗死和再次靶病變血管重建.根據隨訪結果,將患者分為事件組和非事件組.結果 143例患者中,139例完成隨訪,4例失訪,隨訪(19.8±5.1)箇月.長期隨訪中共髮生主要不良心血管事件15例(10.5%),其中死亡3例,心肌梗死1例,再次靶病變血管重建11例.與非事件組比較,事件組的殘餘狹窄較重[(17.7±1.8)%比(15.4±5.0)%,P=0.001],最終最小管腔直徑較小[(2.14±0.22)%比(2.89±0.37)%,P=0.004].Cox迴歸分析顯示,最終最小管腔直徑(OR:0.097,95%可信區間:0.013~0.694,P=0.020)為長期隨訪預後惟一獨立危險因素.結論 糖尿病閤併CTO患者置人DES安全、有效.最終最小管腔直徑可能為長期隨訪事件的重要預測因子.
목적 평개당뇨병합병관상동맥만성완전폐새성(CTO)병변환자치입약물세탈지가(DES)적원기림상예후.방법 회고성분석143례우2006년1월지2007년5월기간련속입원접수경피관상동맥개입치료병치입DES적당뇨병합병CTO병변환자적림상자료,병대환자진행수방.연구종점위주요불양심혈관사건,포괄사망、심기경사화재차파병변혈관중건.근거수방결과,장환자분위사건조화비사건조.결과 143례환자중,139례완성수방,4례실방,수방(19.8±5.1)개월.장기수방중공발생주요불양심혈관사건15례(10.5%),기중사망3례,심기경사1례,재차파병변혈관중건11례.여비사건조비교,사건조적잔여협착교중[(17.7±1.8)%비(15.4±5.0)%,P=0.001],최종최소관강직경교소[(2.14±0.22)%비(2.89±0.37)%,P=0.004].Cox회귀분석현시,최종최소관강직경(OR:0.097,95%가신구간:0.013~0.694,P=0.020)위장기수방예후유일독립위험인소.결론 당뇨병합병CTO환자치인DES안전、유효.최종최소관강직경가능위장기수방사건적중요예측인자.
Objective The aim of this study was to assess the long-term clinical outcome of patients with diabetes mellitus and chronic total occlusion ( CTO) underwent drug-eluting stents ( DES) implantation. Methods Data of 143 consecutive eligible patients from January, 2006 to May, 2007 were retrospectively analyzed. The endpoint of the study was the major adverse cardiac events ( MACE) , including death, myocardial infarction, target lesion revascularization. The patients were divided into two groups, event group and non-event group, according to the result of follow-up. Results Long-term follow-up was finished in 139 (97.2% ) patients. Mean follow-up duration was (19. 8 ±5. 1) months. MACE rate was 10.5% during follow-up: 3 deaths, 1 myocardial infarction and 11 repeated target lesion revascularization with PCI. Compared with the non-event group, the percentage of residual lesion [(17. 7 ± 1.8)% vs. (15. 4±5. 0)% ,P =0. 001] was significantly higher in the event group, however, the final minimal luminal diameter [(2. 14 ±0. 22)% vs. (2. 89 ±0. 37)% ,P = 0. 004] was lower. Cox regression analysis showed that final luminal diameter (OR; 0.097, 95% Cl; 0. 013-0. 694, P = 0.020) was the only dependant predictor at follow-up. Conclusion Final minimal luminal diameter is an independent predictor of MACE during follow-up for patients with diabetes and CTO underwent DES implantation.
