药物洗脱支架置入对糖尿病并发冠心病患者不良心血管事件的影响

The efficacy of the drug-eluting stents in the treatment of coronary artery disease in patients with diabetes

目的评价药物洗脱支架置人对糖尿病并发冠心病患者不良事件的影响。方法对600例行药物洗脱支架植入术的患者进行随访，其中糖尿病患者147例。通过随访术后主要不良心血管事件（包括死亡，非致死性心肌梗死，再次靶病变血运重建和再次靶血管血运重建）和支架内再狭窄的发生率评价药物洗脱支架在糖尿病患者中的疗效。结果糖尿病患者和非糖尿病患者术后的主要不良心血管事件（7．9％与4．9％，P=0．344）和支架内再狭窄（6．0％与4．9％，P=0．540）发生率之间差异元统计学意义。糖尿病患者植入Cypher和TAXUS支架后主要不良心血管事件（7．9％与4．9％，P=0．344）和支架内再狭窄（1．4％与1．9％，P=1．000）发生率之间差异无统计学意义。结论糖尿病患者使用药物洗脱支架是安全有效的，且Cypher和TAXUS两种支架在糖尿病患者中疗效差异无统计学意义。

Objective To evaluate the efficacy of the drug-eluting stents in the treatment of coronary artery diseases in patients with diabetes. Methods This study included a retrospective database of 600 consecutive patients with coronary artery disease who underwent drug-eluting stents implantation in Zhong Shan Hospital, including 147 patients with diabetes. The MACE in this study included death of any cause, nonfatal myocardial infarction,target lesion revascularization and target vessel revascularization. All the MACE were recorded. The efficacy of the drug-eluting stents was evaluated by the incidence of MACE and the rate of in-stent restenosis. Results No significant differences were found concerning the incidence of MACE （ 7. 9% vs 4. 9%, P = 0. 344） as well as the rate of ISR （6.0% vs 4. 9% ,P = 0. 540） between patients with diabetes and patients without diabetes. No significant differences were found concerning the incidence of MACE （7.9% vs 4. 9%, P = 0. 344） as well as the rate of ISR （ 1.4% vs 1.9%, P = 1. 000） between Cypher stentts and TAXUS stents. Conclusion Drug-eluting stents are effective in the treatment of coronary artery disease of patients with diabetes. There was no significant difference in the rate of MACE and in-stent restenosis between the two leading drug-eluting stents of sirolimus eluting Cypher stent and the paclitaxle elnting TAXUS stent.