PCI治疗对于2型糖尿病合并冠心病患者的疗效及对心功能的影响

Therapeutic effect of PCI on patients with type 2 diabetes mellitus complicated coronary heart disease and its influence on cardiac function

目的:研究PCI对T2DM合并CHD患者的疗效及对心功能的影响。方法:本院2014年3月至8月收治的192例CHD患者,按是否合并T2DM,患者被分为CHD组(96例)和CHD+T2DM组(96例);每组又进一步均分为联合治疗组(接受常规药物治疗+PCI,48例)和药物治疗组(仅接受常规药物治疗,48例),疗程1年。观察比较各组疗效、治疗前后舒张期室间隔厚度(IVSTd)、左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)、LVEF,以及随访3年内的主要不良心血管事件(MACE)发生率。结果:CHD联合治疗组的总有效率显著高于CHD药物治疗组(95.83%比70.83%);CHD+T2DM联合治疗组的总有效率显著高于CHD+T2DM药物治疗组(93.75%比68.75%),P均<0.01。在CHD+T2DM组,与药物治疗组比较,联合治疗组治疗后IVSTd [(9.6±1.8)mm比(8.1±1.9)mm]、LVEDd [(46.8±4.9)mm比(42.9±5.4)mm]、LVESd[(33.8±4.9)mm比(30.9±4.7)mm]减小更显著,LVEF [(46.9±5.6)%比(51.1±6.1)%]增大更显著,P均<0.01。CHD联合治疗组的MACE发生率显著低于CHD药物治疗组(4.17%比27.08%);CHD+T2DM联合治疗组的MACE发生率显著高于CHD联合治疗组(22.92%比4.17%),但显著低于CHD+T2DM药物治疗组(41.67%),P<0.05或<0.01。结论:无论是CHD组,还是CHD+T2DM组都是联合治疗的疗效优于药物治疗,而且CHD联合治疗组的MACE发生率显著低于CHD+T2DM联合治疗组,即CHD组预后好于CHD+T2DM组。

Objective:To study therapeutic effect of PCI on T2 DM+CHD patients and its influence on cardiac function.Methods:The 192 CHD patients treated in our hospital from Mar 2014 to Aug 2014,according to complicated T2 DM or not,were divided into CHD group(n=96)and CHD+T2 DM group(n=96);each group was further and equally divided into combined treatment group(received routine medication+ PCI,n=48)and medication group,both groups were treated for one year.Therapeutic effect,end-diastolic interventricular septal thickness(IVSTd),LVEDd,LVESd and LVEF before and after treatment,and incidence rate of MACE within three-year follow-up were observed and compared among above groups.Results:Total effective rate of CHD combined treatment group was significantly higher than that of CHD medication group(95.83%vs.70.83%);that of CHD+T2 DM combined treatment group was also significantly higher than that of CHD+T2 DM medication group(93.75%vs.68.75%),P<0.01 both.In CHD+T2 DM group,compared with medication subgroup,there were significant reductions in IVSTd [(9.6±1.8)mm vs.(8.1±1.9)mm],LVEDd [(46.8±4.9)mm vs.(42.9±5.4)mm]and LVESd[(33.8±4.9)mm vs.(30.9±4.7)mm],and significant rise in LVEF [(46.9±5.6)% vs.(51.1±6.1)%]in combined treatment subgroup,P<0.01 all.Incidence rate of MACE in CHD combined treatment group was significantly lower than that of CHD medication group(4.17%vs.27.08%);that of CHD+T2 DM combined treatment group was significantly higher than that of CHD combined treatment group(22.92% vs.4.17%),but significantly lower than that of CHD+T2 DM medication group(41.67%),P<0.05 or<0.01.Conclusion:No matter CHD group or CHD+T2 DM group,therapeutic effect of combined treatment is always significantly better than that of medication.Incidence rate of MACE in CHD combined treatment group is significantly lower than that of CHD+T2 DM combined treatment group,that is,prognosis of CHD group is better than that of CHD+T2 DM group.