冠状动脉再血管化治疗预后与2型糖尿病控制程度的关系

A study on the relationship between the prognosis in type 2 diabetes mellitus patients undergoing coronary revascularization and the extent of hyperglycaemia

目的 探讨 2型糖尿病病人冠状动脉再血管化治疗预后与血糖控制程度间的关系 ,为预后及二级预防提供有益的指导。方法 对 15 3例冠状动脉旁路移植术 (CABG)及 181例经皮冠状动脉成形术 (PCI)的 2型糖尿病病人进行回顾性分析。术后随访 2～ 3年 ,依据术后临床预后分为良好和不良 ,采用单因素分析比较两组中血糖控制程度的差异 ,采用Logistic回归分析血糖控制不良与再血管化治疗预后不良的相关危险程度。结果 CABG组和PCI组分析结果显示 ,预后不良组比预后良好组血糖控制明显较差 (P =0 0 0 7、0 0 0 8) ,经回归分析示血糖控制不良明显增加预后不良危险性 (OR =2 0 33,P =0 0 0 8和OR =2 4 76 ,P =0 0 0 6 )。结论 2型糖尿病病人经冠状动脉再血管化治疗后其预后与血糖控制程度显著相关。有效地控制血糖于正常水平 ,才有可能改善 2型糖尿病病人冠状动脉再血管化治疗的预后 ,进一步说明对于伴发 2型糖尿病的冠心病病人 ,积极有效控制

Objective To study the relation between hyperglycaemia and the prognosis in patients with type 2 diabetes mellitus undergoing coronary revascularization. Methods Study retrospectively 334 type 2 diabetes mellitus patients underwent coronary revascularization, we compare the incidence of hyperglycaemia between patients with good prognosis and patients with bad prognosis undergoing coronary artery bypass graft and percutaneous transluminal coronary angioplasty. We identify by logistic regression analysis the extent of hyperglycaemia as risk factor in the prognosis individually. Results In patients undergoing coronary artery bypass graft and percutaneous transluminal coronary angioplasty, the incidence of hyperglycaemia is higher in patients with bad prognosis than in patients with good prognosis. It is identified by logistic regression analysis that hyperglycaemia deteriorates the prognosis of patients undergoing coronary artery bypass graft (OR=2.033, P=0.008) and patients undergoing percutaneous transluminal coronary angioplasty (OR=2.476, P=0.006). Conclusion To control hyperglycaemia efficiently following coronary revascularization in patients with type 2 diabetes mellitus is mandatory.