2型糖尿病患者冠状动脉支架植入术后长期随访及生活质量评价

Long-term Follow-up and Quality of Life Assessment in Patients with Type 2 Diabetes after Coronary Stent Implantation

目的:分析糖尿病合并冠心病患者冠状动脉支架植入术(PCI)后长期临床疗效及评价术后生活质量的变化。方法:比较87例糖尿病合并冠心病患者(糖尿病组)及92例无糖尿病冠心病患者(对照组)冠状动脉造影及支架植入情况,并随访两组患者术后2年的临床疗效、不良心脏事件发生率,比较两组患者支架植入术前后生活质量SF-36积分的变化。结果:与对照组相比,糖尿病组患者的冠脉病变更复杂、更严重,两组即刻手术成功率高。术前糖尿病组患者生活质量除精神健康外各维度积分较对照组低(P<0.05);随访2年结果显示,两组生活质量除精神健康外各维度积分较术前均有提高(P<0.05);生活质量各维度积分除躯体疼痛外,其它无显著性差异(P>0.05)。糖尿病组术后2年心绞痛复发率、再次血运重建率高于对照组(P<0.05),但其心性死亡、非致死性心肌梗死的发生率与对照组相当。结论:糖尿病合并冠心病患者PCI后疗效良好,术后远期不良心脏事件发生率较低,术后长期生活质量提高明显。

Objective:To evaluate long-term effectiveness of coronary stenting and to investigate long-term quality of life in patients with type 2 diabetes after coronary stent implantation.Method:Comparing with non-diabetic subjects(control group,n=92),the clinical outcomes of percutaneous coronary intervention(PCI)in 87 with type 2 diabetes and coronary artery disease(diabetes group,n=87);Quality of life were compared between the two groups before and after two years of PCI ;In the two years of follow-up period,occurenace of cardiac events were recorded and compared between the two groups.Results:Comparing with the control group,coronary artery lesion in diabetes group was more serious and complicated.The procedural success rate was high in both groups.Quality of life in the control group was better than that in the diabetes group before PCI.At 2 years follow-up after PCI,all domains except mental health assessed by the 36-items short form health survey(SF-36)improved significantly in both groups,all domains except body pain in the diabetes group were as well as in the control group.Comparing with the control group,the diabetes group had more incidences of long-term adverse cardiac events,owing to a higher percentage of revascularization and angina recurrence.Two groups had a similar incidence of cardiac death,non-fatal myocardial infarction during the follow-up period.Conclusion:Quality of life can be significantly improved in patients with type 2 diabetes and coronary artery disease by PCI.And the adverse cardiac events were low in the long-term after PCI.