糖尿病多支冠状动脉病变患者不同血管重建疗效的比较

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1、万方数据I临床心血管病杂志2007年7月第23卷第7期糖尿病多支冠状动脉病变患者不同血管重建疗效的比较*黎旭1顾承雄2刘晓惠1聂绍平1杜昕1黄方炯2周玉杰1陈方1吕强1康俊平1董建增1吕树铮1吴学思1马长生1·519·[摘要]目的：评价对糖尿病多支冠状动脉病变患者的裸支架(BMS)置入、药物洗脱支架(DES)置入和冠状动脉搭桥手术(CABG)3种不同血管重建的疗效。方法：选择接受血管重建治疗的糖尿病伴多支冠状动脉病变患者427例，比较其BMS、DES和CABG不同治疗方法的疗效和随访2年的临床结果。结果：BMS、DES和CABG3组间住

2、院时期的不良心脑血管事件(MACCE)发生率比较，差异均无统计学意义。2年随访结果中，BMS组、DES组再次血管重建率分别为17．6％、10．4％，均显著高于CABG组的1．9％(P<0．01)；BMS组的总MACCE发生率为23．1％，显著高于CABG组的10．7％(P

3、分类号]R547．1[文献标志码]A[文章编号]1001—1439(2007)07—0519-04EvaluationofdifferentrevascularizationstrategiesindiabeticpatientswithmultivesselabnormalitiesLjX能1L工UXiaohuilNIEShaopin91DUXinlLVQian91KANGJunpin91DONGJianzeng1GUChengxiong2HU_ANGFangjlong2ZHOUYujie1CHENFang1LVShuzheng1WU

4、Xuesi1MAChangsheng1(1DepartmentofCardiology，2DepartmentofHeartSurgery，BeijingAnzhenHospital，CapitalUniverstityofMedicalScience，Beijing，100029，China)AbstractObjective：Thestudyaimstoevaluatethreerevascularizationstrategies，includingbaremetalstent(BMS)implantation，drugeluti

5、ngstent(DES)implantationandcoronaryarterybypasssurgery(CABG)indiabeticpatientswithmultivesselabnormalities．Method：Fourhundredandtwenty—sevenpatientswithdiabetesandmultivessdabnormalitieswhounderwenttherevascularizationinourinstitutionwereenrolledtocomparetheirclinicalout

6、comesduringhospitalizationand2year{ollowupamongBMS，DESandCABGgroups．Result：Nosta—tisticaldifferencesarefoundintherateofin-hospitalmajoradversecardiacandcerebrovascularevents(MACCE)amongtheBMS，DESandCABGgroups．During2yearfollowup，therateofrepeatrevascularizationinBMSgroup

7、was17．6％andMACCEwas23．1％，whichweremuchhigherthanthoseofDESandCABGgroups．TheriskofrepeatrevacularizationinBMSgroupwas16．858(95％CI4．079—69．677，P<0．01)timesthatoftheCABGgroup，andtheriskofMACCEis3，484(95％CI1．565—7．753，P<0．01)timesthatoftheCABGgroup．The2-yearfollowupevent—fre

8、esurvivalofBMSgroupwasmuchlowerthanthatofCABGgroup．IntheDESgroup。therateofrepeatrevascularizationwas10．