糖尿病患者药物洗脱支架植入术后冠脉再狭窄的因素分析(2)
本研究结果显示，支架长度、术前参考血管直径、术后最小管腔直径都是发生再狭窄的预测因素。因此在临床工作中，如果糖尿病患者冠脉病变弥漫，参考血管直径较小，提前预测患者术后再狭窄发生率将会很高，采用CABG进行治疗的临床预后可能更佳。
即使在药物洗脱支架时代，糖尿病依然是支架植入后冠脉再狭窄的重要预测因素，特别是在具有较小基础管腔直径、较小支架术后管腔直径、较长支架长度、目前吸烟及高C反应蛋白浓度的患者。
参考文献：
[1] Wannamethee SG,Shaper AG,Lennon L.Cardiovascular disease incidence and mortality in older men with diabetes and in men with coronary heart disease[J].Heart,2004,90:1398-403.
[2] Kastrati A,Schomig A,Elezi S,et al.Predictive factors of restenosis after coronary stent placement[J].J Am Coll Cardiol,1997,30:1428-1436.
[3] Kornowski R,Mintz GS,Kent KM,et al.Increased restenosis in diabetes mellitus after coronary interventions is due to exaggerated intimal hyperplasia:A serial intravascular ultrasound study[J].Circulation,1997,95:1366-1369.
[4] Peter M,Neeraj P,Sanh B,et al.Predictors of angiographic restenosis after coronary intervention in patients with diabetes mellitus[J].Am Heart J,2003,145:1013-1021.
[5] Sousa JE,Costa MA,Sousa AG,et al.Two-year angiographic and intravascular ultrasound follow-up after implantation of sirolimus-eluting stents in human coronary arteries[J].Circulation，2003，107(3):381-383.
[6] Beckman JA,Creager MA,Libby P.Diabetes and atherosclerosis:Epidemiology,pathophysiology,and management[J].JAMA,2002,287:2570-2581.
[7] Yusuf S,Zhao F,Mehta SR,et al.Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation[J].N Engl J Med,2001,345:494-502.
[8] Nishikawa H,Miura S,Shimomura H,et al.Combined treatment with statin and angiotensin-receptor blocker after stenting as a useful strategy for prevention of coronary restenosis[J].J Cardiol,2005,45(3):107-113.
[9] Guneri S,Baris N,Aytekin D,et al.The relationship between angiotensin converting enzyme gene polymorphism,coronary artery disease,and stent restenosis:The role of angiotensin converting enzyme inhibitors in stent restenosis in patients with diabetes mellitus[J].Int Heart J,2005,46(5):889-897.
作者简介：罗兵，副主任医师，现工作于湖北省武汉市中西医结合医院/武汉市第一医院(邮编：430022)；贺立群、 周军，工作于湖北省武汉市中西医结合医院武汉市第一医院。
(收稿日期：2011-05-02)
(本文编辑 王雅洁), http://www.100md.com(罗兵 贺立群 周军)
即使在药物洗脱支架时代，糖尿病依然是支架植入后冠脉再狭窄的重要预测因素，特别是在具有较小基础管腔直径、较小支架术后管腔直径、较长支架长度、目前吸烟及高C反应蛋白浓度的患者。
参考文献：
[1] Wannamethee SG,Shaper AG,Lennon L.Cardiovascular disease incidence and mortality in older men with diabetes and in men with coronary heart disease[J].Heart,2004,90:1398-403.
[2] Kastrati A,Schomig A,Elezi S,et al.Predictive factors of restenosis after coronary stent placement[J].J Am Coll Cardiol,1997,30:1428-1436.
[3] Kornowski R,Mintz GS,Kent KM,et al.Increased restenosis in diabetes mellitus after coronary interventions is due to exaggerated intimal hyperplasia:A serial intravascular ultrasound study[J].Circulation,1997,95:1366-1369.
[4] Peter M,Neeraj P,Sanh B,et al.Predictors of angiographic restenosis after coronary intervention in patients with diabetes mellitus[J].Am Heart J,2003,145:1013-1021.
[5] Sousa JE,Costa MA,Sousa AG,et al.Two-year angiographic and intravascular ultrasound follow-up after implantation of sirolimus-eluting stents in human coronary arteries[J].Circulation，2003，107(3):381-383.
[6] Beckman JA,Creager MA,Libby P.Diabetes and atherosclerosis:Epidemiology,pathophysiology,and management[J].JAMA,2002,287:2570-2581.
[7] Yusuf S,Zhao F,Mehta SR,et al.Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation[J].N Engl J Med,2001,345:494-502.
[8] Nishikawa H,Miura S,Shimomura H,et al.Combined treatment with statin and angiotensin-receptor blocker after stenting as a useful strategy for prevention of coronary restenosis[J].J Cardiol,2005,45(3):107-113.
[9] Guneri S,Baris N,Aytekin D,et al.The relationship between angiotensin converting enzyme gene polymorphism,coronary artery disease,and stent restenosis:The role of angiotensin converting enzyme inhibitors in stent restenosis in patients with diabetes mellitus[J].Int Heart J,2005,46(5):889-897.
作者简介：罗兵，副主任医师，现工作于湖北省武汉市中西医结合医院/武汉市第一医院(邮编：430022)；贺立群、 周军，工作于湖北省武汉市中西医结合医院武汉市第一医院。
(收稿日期：2011-05-02)
(本文编辑 王雅洁), http://www.100md.com(罗兵 贺立群 周军)