CAJ | 학술논문

目的：比较2型糖尿病（type 2 diabetes mellitus，T2DM）合并冠心病多支血管病变患者接受经皮冠状动脉介入治疗（ percutaneous coronary intervention ，PCI）或冠状动脉旁路移植术（ coronary artery by-pass graft，CABG）3年后的预后情况，探讨该类患者如何选择再血管化治疗方式。方法选择2009年5月1日至2010年5月31日于天津市胸科医院连续进行的冠状动脉造影（ coronary angiography ，CAG）确诊T2DM伴多支血管病变并成功行PCI或CABG治疗且病例及随访资料完整者，进行为期3年的随访，收集患者一般情况、临床指标、实验室检查指标等信息，分析死亡、心肌梗死、再次血运重建、再发心绞痛、心力衰竭、卒中等主要不良心脑血管事件（ major adverse cardio cerebral events ，MACCE）。结果3年期随访显示，PCI组MACCE发生率显著高于CABG组（31.58％ vs 17.68％，P＜0.01），PCI组心源性死亡（4.82％vs 1.10％，P＜0.05）、心肌梗死（4.39％ vs 1.10％，P＜0.05）及再发心绞痛（17.27％ vs 10.50％， P＜0.05）发生率较高。结论与PCI相比，CABG仍然是目前T2DM合并多支血管病变患者血运重建治疗的更好方法。
목적：비교2형당뇨병（type 2 diabetes mellitus，T2DM）합병관심병다지혈관병변환자접수경피관상동맥개입치료（ percutaneous coronary intervention ，PCI）혹관상동맥방로이식술（ coronary artery by-pass graft，CABG）3년후적예후정황，탐토해류환자여하선택재혈관화치료방식。방법선택2009년5월1일지2010년5월31일우천진시흉과의원련속진행적관상동맥조영（ coronary angiography ，CAG）학진T2DM반다지혈관병변병성공행PCI혹CABG치료차병례급수방자료완정자，진행위기3년적수방，수집환자일반정황、림상지표、실험실검사지표등신식，분석사망、심기경사、재차혈운중건、재발심교통、심력쇠갈、졸중등주요불양심뇌혈관사건（ major adverse cardio cerebral events ，MACCE）。결과3년기수방현시，PCI조MACCE발생솔현저고우CABG조（31.58％ vs 17.68％，P＜0.01），PCI조심원성사망（4.82％vs 1.10％，P＜0.05）、심기경사（4.39％ vs 1.10％，P＜0.05）급재발심교통（17.27％ vs 10.50％， P＜0.05）발생솔교고。결론여PCI상비，CABG잉연시목전T2DM합병다지혈관병변환자혈운중건치료적경호방법。
Objective To compare two different revascularization methods in type 2 diabetes mellitus (T2DM) patients with multivessel coronary artery disease treated by percutaneous coronary intervention (PCI) and coronary artery bypass graft ( CABG) .Methods T2DM patients with multivessel disease undergoing success-ful PCI or CABG were enrolled in the study .They were diagnosed by coronary angiography ( CAG) in Tianjin Chest Hospital from May 2009 to May 2010 whose.The patients were followed up for 3 years.The information of patients including physical performance , clinical features , and laboratory examination results were collected .The major ad-verse cardio cerebral events(MACCE)including death, myocardial infarction(MI), revascularization, angina pecto-ris, heart failure, and stroke were collected.Results During the 3 years of follow-up, MACCE(31.58% vs 17.68%, P<0.01), death(4.82%vs 1.10%, P<0.05), MI(4.39%vs 1.10%, P<0.05), angina pectoris (17.27%vs 10.50%, P<0.05)occurred more frequently in PCI group than in CABG group .Conclusion Evi-dences now tend to support CABG for revascularization in T 2DM patients with multivessel disease .