2型糖尿病、糖尿病前期、非糖尿病患者PCI术后远期预后的比较

Comparison of long-term prognosis after percutaneous coronary intervention in patients with type 2 diabetes mellitus,impaired glucose tolerance and non-diabetes mellitus

目的探讨糖尿病前期(IGT)与2型糖尿病(T2DM)对冠心病经皮冠状动脉介入治疗(PCI)术后5年预后的影响。方法采用便利抽样法,选择2011年12月—2013年9月的165例接受PCI治疗患者,根据口服糖耐量试验结果分为T2DM组(54例)、IGT组(52例)、非糖尿病(NDM)组(59例)。患者出院后门诊随访,记录患者在PCI术后5年之内的主要心血管不良事件(MACE)的发生情况,包括心源性死亡、非致死性再梗、非致死性卒中、心力衰竭再住院。结果术后5年随访结果显示,72例患者发生MACE,其中15例死于心源性死亡,11例因心力衰竭入院,5例为非致死性卒中,41例为非致死性再梗。72例发生MACE的患者中,NDM组17例,IGT组30例,T2DM组25例,IGT组高于NDM组,差异有统计学意义(P<0.05),但与T2DM组比较差异无统计学意义(P>0.05)。41例非致死性再梗患者中,NDM组10例,IGT组19例,T2DM组12例,IGT组高于NDM组及T2DM组,差异有统计学意义(P<0.05)。结论IGT会增加PCI后患者再次发生心肌梗死的风险,是导致MACE事件发生的危险因素。

Objective To explore effects of impaired glucose tolerance(IGT)and type 2 diabetes mellitus(T2DM)on the 5-year prognosis after percutaneous coronary intervention(PCI)for coronary heart disease.Methods A total of 165 patients receiving PCI from December 2011 to September 2013 were selected by the convenient sampling method.According to the results of oral glucose tolerance test,they were divided into T2DM group(54 cases),IGT group(52 cases),and non-diabetes mellitus(NDM)group(59 cases).The patients were followed up in the outpatient clinic after discharge and recorded the occurrence of major adverse cardiovascular events(MACE)of patients within 5 years after PCI,including cardiogenic death,non-fatal reinfarction,non-fatal stroke and re-hospitalization for heart failure.Results The 5-year follow-up results showed that 72 patients had MACE,of which 15 died of cardiogenic death,11 were admitted to the hospital due to heart failure,5 had non-fatal stroke and 41 had non-fatal reinfarction.Among the 72 patients with MACE,there were 17 cases in the NDM group,30 cases in the IGT group and 25 cases in the T2DM group.The IGT group was higher than the NDM group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference between the IGT group and the T2DM group(P>0.05).Among the 41 non-fatal reinfarction patients,there were 10 cases in the NDM group,19 cases in the IGT group and 12 cases in the T2DM group.The IGT group was higher than the NDM group and the T2DM group,and the differences were statistically significant(P<0.05).Conclusions IGT increases the risk of myocardial infarction in patients after PCI,which is a risk factor for MACE events.