[1]陈瑞阳.不同血运重建方案下冠状动脉多支病变并发糖尿病高龄患者生存状况比较[J].新乡医学院学报,2017,34(6):500-502.[doi:10.7683/xxyxyxb.2017.06.012]
 CHEN Rui-yang.Comparison of survival condition of elderly patients with multivessel coronary artery disease complicated with diabetes mellitus underwent different revascularization[J].Journal of Xinxiang Medical University,2017,34(6):500-502.[doi:10.7683/xxyxyxb.2017.06.012]
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不同血运重建方案下冠状动脉多支病变并发糖尿病高龄患者生存状况比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年6
页码:
500-502
栏目:
临床研究
出版日期:
2017-06-05

文章信息/Info

Title:
Comparison of survival condition of elderly patients with multivessel coronary artery disease complicated with diabetes mellitus underwent different revascularization
作者:
陈瑞阳
(长垣县人民医院心内科,河南 长垣 453400)
Author(s):
CHEN Rui-yang
(Department of Cardiology,the People′s Hospital of Changyuan County,Changyuan 453400,Henan Province,China)
关键词:
经皮冠状动脉介入冠状动脉旁路移植术冠状动脉多支病变糖尿病生存状况
Keywords:
percutaneous coronary interventioncoronary artery bypass graftingmultivessel coronary artery diseasediabetes mellitussurvival condition
分类号:
R543.3
DOI:
10.7683/xxyxyxb.2017.06.012
文献标志码:
A
摘要:
目的 比较不同血运重建方案下冠状动脉多支病变并发糖尿病(DM)高龄患者的生存状况。方法 选择2013年6月至2015年6月长垣县人民医院收治的冠状动脉多支病变并发DM高龄(年龄≥80岁)患者96例,其中35例行经皮冠状动脉介入(PCI)治疗(PCI组),61例行冠状动脉旁路移植术(CABG)治疗(CABG组),比较2组患者的病变特点、预后及生存状况,并分析冠状动脉多支病变并发DM高龄患者死亡的相关因素。结果 围术期PCI组患者主要不良心血管事件(MACE)、脑血管事件发生率和全因死亡率显著低于CABG组(P<0.05),但2组患者非致死性急性心肌梗死发生率比较差异无统计学意义(χ2=1.689,P>0.05)。1 a后PCI组患者脑血管事件发生率显著低于CABG组(χ2=6.536,P<0.05),再次血运重建率显著高于CABG组(χ2=6.158,P<0.05);但2组患者MACE发生率、非致死性急性心肌梗死发生率、全因死亡率及心脏性猝死率比较差异均无统计学意义(P>0.05)。Cox多因素分析显示,年龄、血红蛋白水平、血糖水平、左心室射血分数及高血压是冠状动脉多支病变并发DM高龄患者死亡的独立危险因素(P<0.05)。结论 PCI治疗能够降低冠状动脉多支病变并发DM高龄患者脑血管事件发生率,但再次血运重建率较高;应针对影响患者生存的相关因素,采取相应的干预措施。
Abstract:
Objective To compare the survival condition of elderly patients with multivessel coronary artery disease complicated with diabetes mellitus(DM) underwent different revascularization.Methods Ninety-six elderly patients(≥80 years old) with multivessel coronary artery disease and DM were selected from June 2013 to June 2015 in the People′s Hospital of Changyuan County.Among them,35 cases were treated with percutaneous coronary intervention(PCI group),and the other 61 cases were treated with coronary artery bypass grafting (CABG group).The disease characteristics,prognosis and survival condition were compared between the two groups.The related factors for dead in elderly patients with multivessel coronary artery disease and DM were analyzed.Results The rates of major adverse cardiovascular events (MACE),cerebrovascular events and all-cause death in PCI group were significantly lower than those in CABG group during perioperative period (P<0.05);but there was no significant difference in the incidence of nonfatal acute myocardial infarction between the two groups (χ2=1.689,P>0.05).One year later,the incidence of cerebrovascular events in PCI group was significantly lower than that in CABG group (χ2=6.536,P<0.05),and the rate of repeat revascularization in PCI group was significantly higher than that in CABG group (χ2=6.158,P<0.05),but there was no significant difference in the incidences of MACE and nonfatal acute myocardial infarction,the rates of all-cause death and cardiac death between the two groups (P>0.05).Cox multivariate analysis showed that age,hemoglobin level,blood glucose level,left ventricular ejection fraction and hypertension were the independent risk factors for death in patients with multivessel coronary artery disease complicated with DM (P<0.05).Conclusion PCI can reduce the incidence of cerebrovascular events in elderly patients with multivessel coronary artery disease complicated with DM,but the rate of repeat revascularization is higher.The appropriate intervention measures should be taken according to the factors affecting the survival of the patients.

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更新日期/Last Update: 2017-06-05