糖尿病与冠脉支架再狭窄的关系分析

Analysis the Relationship between Diabetes Mellitus and Coronary Stenting Restenosis

目的:探讨糖尿病与冠脉支架术后再狭窄的关系。方法:回顾性分析2000年6月-2002年3月成功进行PCI+Stenting治疗并复查冠脉造影者134例冠心病临床资料。根据直径狭窄是否≥50%,将其分为再狭窄组和未再狭窄组,并分析冠心病相关危险因素与支架内再狭窄的关系,探讨糖尿病是否为支架内再狭窄的独立危险因素。结果:134例共置入181只支架,其中61例(75只)发生支架内再狭窄,6个月再狭窄率为41.2%。在无再狭窄组和再狭窄组男性分别占78.9%和89.8%(P=0.147)。两组平均年龄(62.7±10.4岁)。高血压患病率(58.9%vs65.6%),高血压分级,高血压年限,吸烟,入院TC,LDL,在统计学上无显著差异。在冠心病的危险因素中,糖尿病病人在再狭窄组有12例占19.7%,无再狭窄组只有3例占4.2%(P=0.004);再狭窄组的入院血糖水平为5.70±1.56mmol/L,明显高于无再狭窄组5.14±0.82mmol/L(P=0.01)。结论:糖尿病是支架内再狭窄最有力的预测因子,而入院时血糖水平可能是支架内再狭窄发生的独立危险因子。

Objective： To study the relationship between diabetes mellitus and coronary instent restenosis（ISR）, Methods： Restrospective analysed 134 patients with coronary heart disease who bad under gone percutaneous coronary intervention （PCI ＋ stenting） at the period from Jun 2000 to Mar 2002. After 6 months of implantation angioplasty was done in all patients. The patients whose coronary diameter≥ 50% were divided into 2 groups： ISR group and non ISR group. This paper analysed the relation between risk factors of coronary heart disease and coronary in - stent restenosis. Among these risk factors to find out whether the diabetes mellitus was the independent risk factor for restenosis. Results： In 134 patients, 181 stents were implanted and 75 stents were restenosed （61 patients）. The 6 month restenosis rate was 41.2%. Among 61 patients,12 with diabetes mellitus （19.7%） ,while 73 non ISR group only 3 were diabetes mellitus （4. 2% ,P= 0. 004）. Diabetes mellitus in ISR group was markedly increased. Moreover blood glucose in admission ISR group was 5.70±1.56mmol/L, non ISR group was 5.14±0.28mmol/L（P=0.01 ）. Blood glucose in ISR group was much higher than that of non ISR group. Conclusion： Blood glucose level could be an independent risk factor for the occurrence of in- stent restenosis,and increased the incidence of restenosis.