中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
6期
683-686
,共4页
武云涛%田国祥%张薇%夏常泉%王晓兵%姚璐%李响%张晓冬%孙艳明%高迎春
武雲濤%田國祥%張薇%夏常泉%王曉兵%姚璐%李響%張曉鼕%孫豔明%高迎春
무운도%전국상%장미%하상천%왕효병%요로%리향%장효동%손염명%고영춘
冠心病%2型糖尿病%冠状动脉旁路移植术%经皮冠状动脉介入术%冠状动脉多支病变%药物洗脱支架
冠心病%2型糖尿病%冠狀動脈徬路移植術%經皮冠狀動脈介入術%冠狀動脈多支病變%藥物洗脫支架
관심병%2형당뇨병%관상동맥방로이식술%경피관상동맥개입술%관상동맥다지병변%약물세탈지가
Coronary heart disease%Type 2 diabetes mellitus%Coronary artery bypass grafting%Percutaneous coronary intervention%Coronary multivessel lesions%Drug eluting stent
目的:比较冠状动脉粥样硬化性心脏病(冠心病)合并2型糖尿病冠状动脉多支病变患者经皮冠状动脉介入治疗(PCI)置入药物涂层支架(DES)与冠状动脉旁路移植术(CABG)后远期疗效。方法连续入选2002年12月至2008年12月住院期间的冠心病合并2型糖尿病患者,并成功行择期血运重建的多支冠状动脉病变患者,分为CABG组(n=270),DES组(n=285)。随访5年,从术后30 d开始到5年止结束,随访包括全因死亡、心源性死亡、非致死性卒中、非致死性心肌梗死、心绞痛复发和再次血运重建的主要不良心脑血管事件(MACE)。结果入选患者随访率100%。CABG组与DES组两组间5年全因死亡率(1.11%vs.1.40%)、心源性死亡率(0%vs.0%)、非致死性卒中发生率(2.22%vs.2.81%)无统计学差异(P>0.05)。DES组非致死性心肌梗死发生率(3.15%)、心绞痛复发率(17.89%)、再次血运重建率(12.28%)均高于CABG组(分别为1.11,5.56%,0.74%),差异均有统计学意义(P<0.05~0.01)。结论多支冠状动脉病变合并2型糖尿病患者CABG与PCI治疗5年生存率无明显差异,但多支冠状动脉病变合并2型糖尿病患者DES支架置入远期心绞痛复发率、再次血运重建率,非致死性心肌梗死发生率高于 CABG组。
目的:比較冠狀動脈粥樣硬化性心髒病(冠心病)閤併2型糖尿病冠狀動脈多支病變患者經皮冠狀動脈介入治療(PCI)置入藥物塗層支架(DES)與冠狀動脈徬路移植術(CABG)後遠期療效。方法連續入選2002年12月至2008年12月住院期間的冠心病閤併2型糖尿病患者,併成功行擇期血運重建的多支冠狀動脈病變患者,分為CABG組(n=270),DES組(n=285)。隨訪5年,從術後30 d開始到5年止結束,隨訪包括全因死亡、心源性死亡、非緻死性卒中、非緻死性心肌梗死、心絞痛複髮和再次血運重建的主要不良心腦血管事件(MACE)。結果入選患者隨訪率100%。CABG組與DES組兩組間5年全因死亡率(1.11%vs.1.40%)、心源性死亡率(0%vs.0%)、非緻死性卒中髮生率(2.22%vs.2.81%)無統計學差異(P>0.05)。DES組非緻死性心肌梗死髮生率(3.15%)、心絞痛複髮率(17.89%)、再次血運重建率(12.28%)均高于CABG組(分彆為1.11,5.56%,0.74%),差異均有統計學意義(P<0.05~0.01)。結論多支冠狀動脈病變閤併2型糖尿病患者CABG與PCI治療5年生存率無明顯差異,但多支冠狀動脈病變閤併2型糖尿病患者DES支架置入遠期心絞痛複髮率、再次血運重建率,非緻死性心肌梗死髮生率高于 CABG組。
목적:비교관상동맥죽양경화성심장병(관심병)합병2형당뇨병관상동맥다지병변환자경피관상동맥개입치료(PCI)치입약물도층지가(DES)여관상동맥방로이식술(CABG)후원기료효。방법련속입선2002년12월지2008년12월주원기간적관심병합병2형당뇨병환자,병성공행택기혈운중건적다지관상동맥병변환자,분위CABG조(n=270),DES조(n=285)。수방5년,종술후30 d개시도5년지결속,수방포괄전인사망、심원성사망、비치사성졸중、비치사성심기경사、심교통복발화재차혈운중건적주요불양심뇌혈관사건(MACE)。결과입선환자수방솔100%。CABG조여DES조량조간5년전인사망솔(1.11%vs.1.40%)、심원성사망솔(0%vs.0%)、비치사성졸중발생솔(2.22%vs.2.81%)무통계학차이(P>0.05)。DES조비치사성심기경사발생솔(3.15%)、심교통복발솔(17.89%)、재차혈운중건솔(12.28%)균고우CABG조(분별위1.11,5.56%,0.74%),차이균유통계학의의(P<0.05~0.01)。결론다지관상동맥병변합병2형당뇨병환자CABG여PCI치료5년생존솔무명현차이,단다지관상동맥병변합병2형당뇨병환자DES지가치입원기심교통복발솔、재차혈운중건솔,비치사성심기경사발생솔고우 CABG조。
Objective To compare the long-term curative effects between implanting drug eluting stent (DES) during percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with coronary multivessel lesions of coronary heart disease (CHD) complicating type 2 diabetes mellitus (T2DM). Methods The patients with successful selective revascularization were chosen continuously from Dec. 2002 to Dec. 2008, and divided into CABG group (n=270) and DES group (n=285). All patients were followed up for 5 years from 30 d after the operation to the 5th year. The content of follow-up included major adverse cardiovascular events (MACE), such as all-cause mortality, cardiac death, non-fatal stroke, non-fatal myocardial infarction, angina recurrence and onemore revascularization.Results The follow-up rate was 100% in all patients. In 2 groups, 5-year all-cause mortality (1.11%vs. 1.40%), rate of cardiac death (0% vs. 0%) and incidence of non-fatal stroke (2.22%vs. 2.81%) had no statistical difference (P>0.05). In DES group, incidence of non-fatal myocardial infarction (3.15%), angina recurrent rate (17.89%) and onemore revascularization rate (12.28%) were higher than those in CABG group (1.11, 5.56%, 0.74%, andP<0.05~P<0.01).Conclusion CABG and PCI have no significant difference in 5-year survival rate in patients with coronary multivessel lesions of CHD complicating T2DM, while long-term angina recurrent rate, onemore revascularization rate and incidence of non-fatal myocardial infarction are higher in DES group than those in CABG group.