药物洗脱支架对冠心病合并2型糖尿病患者的临床疗效

Effect of drug-eluting stents on patients with type 2 diabetes and coronary artery disease

目的：评价药物洗脱支架在冠心病合并2型糖尿病患者中的临床疗效。方法：68例冠心病合并2型糖尿病患者接受冠脉内原发病变药物洗脱支架置入(SES组)；对照组(BS组)是从我科资料库中抽取的原发病变置入普通支架的56例冠心病合并2型糖尿病患者。结果：术后1年内随访结果SES组与BS组手术成功率相似(分别为97．1%与98．2%,P=1．00)。SES组与BS组累计1年内主要不良心脏事件发生率分别为19．1%与35．7%(P=0．037,OR=0．425,95%CI：0．188～0．961),再次血运重建率为10．3%与25．0%(P=0．03,OR=0．344,95%CI：0．128～0．925),死亡、急性心肌梗死无差异。结论：药物洗脱支架较普通支架显著降低糖尿病患者冠脉介入治疗的1年主要不良心脏事件。

Objective：To evaluate the clinical outcomes of patients with coronary artery disease and type 2 diabetes who underwent elective percutaneous coronary intervention. Methods： From December 2002, a policy of routine sirolimus-eluting stents（SES） implantation has been instituted in our hospital. During 2 years of enrollment, a total of 68 consecutive diabetic patients with coronary lesions were electively treated with SES （SES group）. A similar group for comparison comprised 56 consecutive patients treated with bare metal stents in the preceding period （BS group）. Results： After 1-year follow-up, the cumulative rate of major adverse cardiac events （death, myocardial in farction, and any repeat revascularization） was 19. 1% in the SES group versus 35.7% in the BS group （P=0. 037,OR=0. 425 ,95%CI： 0. 188-0. 961）, mainly due to a marked reduction in the need for repeat revascularization（10.3% versus 25.0%, P = 0. 03 , OR = 0. 344,95% CI 0. 128 0. 925）. Conclusions： Routine utilization of SES for diabetic patients significantly reduces the rate of adverse cardiac events at 1 year compared to bare metal .