糖尿病患者冠状动脉支架术后初步研究(摘要)
作者：厉锦华 王彬尧 朱顺和 何奔 张清 黄定九 刘建平
单位：上海市，上海第二医科大学附属仁济医院 心内科(200001)
关键词：
中国循环杂志99zk53 目的：糖尿病患者经皮冠状动脉腔内成形术(PTCA)术后心脏并发症多，后期再狭窄率高。糖尿病伴多支冠状动脉病变支架内再狭窄更是争论不休。
方法：126例冠心病患者，非胰岛素依赖性糖尿病(NIDDM)20例，非糖尿病者(Nondiabetics)106例，进行常规的PTCA Stent介入治疗。冠状动脉造影显示分别为病变长度(mm)NIDDM 12.0±3.42,Nondiabetics 10.2±4.54,参考血管(mm)2.80±0.25,2.95±0.42,术前最小管腔(mm)0.83±0.46,1.20±0.48,术后最小管腔(mm)2.60±0.34,2.94±0.62,术前狭窄分别(86±12)%,(75±15)%,术后狭窄分别(10±2)%,(5±3)%,手术成功。对术后近期、远期临床结果，心脏并发症进行对比分析。
, 百拇医药
结果：全部患者住院期间无死亡。4～36个月门诊随访发现，心脏并发症NIDDM 4例(20%),Nondiabetics 4例(3.8%)。靶段血管再建术(TLR)NIDDM 10例患者中5例再做PTCA Stent手术，另5例因三支病变做冠状动脉旁路移植术(CABG)。Nondiabetics是5例，其中4例再做PTCA Stent手术，另1例做CABG。NIDDM远期无心脏并发症存活者比Nondiabetics明显低(10例，50%/99例，9.3%)。
结论：NIDDM PTCA Stent术后心脏并发症高，TLR多，无心脏并发症存活者低。NIDDM伴多支病变应首选CABG。
A Preliminary Study of Coronary Stent in Diabetic Patients (Abstract)
Department of Cordiology, Ren Ji Hospital, Shanghai Second Medical University, Shanghai (200001)
, 百拇医药
Li Jinhua, Wang Binyao, Zhu Shunhe, et al.
Objective: Diabetic patients (pts) have a greater potential of cardiac events and restenosis following balloon angioplasty. The impact of diabetes mellitus (DM), especially multivessel disease, on in-stent restenosis an issue in debat.
Methods: We studied 126 (non-insulin-dependent DM, NIDDM, n=20, Nondiabetics, n=106) consecutive pts (144 lesions) with coronary heart disease (CHD) treated with percutaneous transluminal coronary angioplasty (PTCA), NIR PRIMO STENT, AVE MICRO STENT implantation using conventional coronary angiographic technique. Quantitative angiographic results showed: Lesion Length (mm) 12.00±3.42, 10.2±4.54, reference inner diameter of the vessel before stenting (mm) 2.80±0.25, 2.95±0.42, minimal inner diameter before stenting (mm) 0.83±0.46, 1.20±0.48, minimal inner diameter after stenting (mm) 2.60±0.34, 2.94±0.62, Prestenting stenosis (%) 86±12, 75±15, Poststenting stenosis (%) 10±2, 5±3, in NIDDM and non-diabetic pts, respectively. Procedural success, acute and late cardiac events, clinical outcome were compared according to the diabetic status.
, http://www.100md.com
Results: No in-hospital death was occurred in this study. During follow-up (4～36 months), major cardiac events occurred in 4 pts (20%) in NIDDM, 4 pts (3.8%) in nondiabetics. Target lesion revascularization (TLR) was performed in 10 pts (50%) in NIDDM. PTCA stent was performed in 5 pts and coronary arthery bypass graft (CABG) in another 5 pts with three vessel disease. TLR in 5 pts (4.7%) in nondiabetics, including 4 PTCA stent and 1 CABG. Late cardiac enent-free survival (death, myocardial infarction, TLR was excluded) was significantly lower in NIDDM (10 pts, 50%) compared with nondiabetic pts (99 pts, 93%).
Conclusion: In a series of pts treated by elective PTCA stent implantation, NIDDM pts were at higher risk of heart complications and subsequent TLR, as a result, had a significantly lower cardiac event-free survival rate. CABG was the best chsice for NIDDM with multivessel disease., http://www.100md.com
单位：上海市，上海第二医科大学附属仁济医院 心内科(200001)
关键词：
中国循环杂志99zk53 目的：糖尿病患者经皮冠状动脉腔内成形术(PTCA)术后心脏并发症多，后期再狭窄率高。糖尿病伴多支冠状动脉病变支架内再狭窄更是争论不休。
方法：126例冠心病患者，非胰岛素依赖性糖尿病(NIDDM)20例，非糖尿病者(Nondiabetics)106例，进行常规的PTCA Stent介入治疗。冠状动脉造影显示分别为病变长度(mm)NIDDM 12.0±3.42,Nondiabetics 10.2±4.54,参考血管(mm)2.80±0.25,2.95±0.42,术前最小管腔(mm)0.83±0.46,1.20±0.48,术后最小管腔(mm)2.60±0.34,2.94±0.62,术前狭窄分别(86±12)%,(75±15)%,术后狭窄分别(10±2)%,(5±3)%,手术成功。对术后近期、远期临床结果，心脏并发症进行对比分析。
, 百拇医药
结果：全部患者住院期间无死亡。4～36个月门诊随访发现，心脏并发症NIDDM 4例(20%),Nondiabetics 4例(3.8%)。靶段血管再建术(TLR)NIDDM 10例患者中5例再做PTCA Stent手术，另5例因三支病变做冠状动脉旁路移植术(CABG)。Nondiabetics是5例，其中4例再做PTCA Stent手术，另1例做CABG。NIDDM远期无心脏并发症存活者比Nondiabetics明显低(10例，50%/99例，9.3%)。
结论：NIDDM PTCA Stent术后心脏并发症高，TLR多，无心脏并发症存活者低。NIDDM伴多支病变应首选CABG。
A Preliminary Study of Coronary Stent in Diabetic Patients (Abstract)
Department of Cordiology, Ren Ji Hospital, Shanghai Second Medical University, Shanghai (200001)
, 百拇医药
Li Jinhua, Wang Binyao, Zhu Shunhe, et al.
Objective: Diabetic patients (pts) have a greater potential of cardiac events and restenosis following balloon angioplasty. The impact of diabetes mellitus (DM), especially multivessel disease, on in-stent restenosis an issue in debat.
Methods: We studied 126 (non-insulin-dependent DM, NIDDM, n=20, Nondiabetics, n=106) consecutive pts (144 lesions) with coronary heart disease (CHD) treated with percutaneous transluminal coronary angioplasty (PTCA), NIR PRIMO STENT, AVE MICRO STENT implantation using conventional coronary angiographic technique. Quantitative angiographic results showed: Lesion Length (mm) 12.00±3.42, 10.2±4.54, reference inner diameter of the vessel before stenting (mm) 2.80±0.25, 2.95±0.42, minimal inner diameter before stenting (mm) 0.83±0.46, 1.20±0.48, minimal inner diameter after stenting (mm) 2.60±0.34, 2.94±0.62, Prestenting stenosis (%) 86±12, 75±15, Poststenting stenosis (%) 10±2, 5±3, in NIDDM and non-diabetic pts, respectively. Procedural success, acute and late cardiac events, clinical outcome were compared according to the diabetic status.
, http://www.100md.com
Results: No in-hospital death was occurred in this study. During follow-up (4～36 months), major cardiac events occurred in 4 pts (20%) in NIDDM, 4 pts (3.8%) in nondiabetics. Target lesion revascularization (TLR) was performed in 10 pts (50%) in NIDDM. PTCA stent was performed in 5 pts and coronary arthery bypass graft (CABG) in another 5 pts with three vessel disease. TLR in 5 pts (4.7%) in nondiabetics, including 4 PTCA stent and 1 CABG. Late cardiac enent-free survival (death, myocardial infarction, TLR was excluded) was significantly lower in NIDDM (10 pts, 50%) compared with nondiabetic pts (99 pts, 93%).
Conclusion: In a series of pts treated by elective PTCA stent implantation, NIDDM pts were at higher risk of heart complications and subsequent TLR, as a result, had a significantly lower cardiac event-free survival rate. CABG was the best chsice for NIDDM with multivessel disease., http://www.100md.com