文章摘要
李 渊,徐桂冬,王 熙,韩 震,马雪兴,孙康云.急性心肌梗死合并2型糖尿病患者直接经皮冠脉介入治疗术后的随访研究[J].南京医科大学学报,2018,(4):514~517
急性心肌梗死合并2型糖尿病患者直接经皮冠脉介入治疗术后的随访研究
Clinical outcomes of acute myocardial infarction patients with type 2 diabetes mellitus after primary percutaneous coronary intervention
投稿时间:2018-01-23  
DOI:10.7655/NYDXBNS20180418
中文关键词: 急性心肌梗死  2型糖尿病  经皮冠状动脉介入治疗
英文关键词: acute myocardial infarction  type 2 diabetes mellitus  percutaneous coronary intervention
基金项目:苏州市临床重点病种诊疗技术专项(LCZX201610)
作者单位
李 渊 南京医科大学附属苏州市立医院北区心脏科江苏 苏州 215008 
徐桂冬 南京医科大学附属苏州市立医院北区心脏科江苏 苏州 215008 
王 熙 南京医科大学附属苏州市立医院北区心脏科江苏 苏州 215008 
韩 震 南京医科大学附属苏州市立医院北区心脏科江苏 苏州 215008 
马雪兴 南京医科大学附属苏州市立医院北区心脏科江苏 苏州 215008 
孙康云 南京医科大学附属苏州市立医院北区心脏科江苏 苏州 215008 
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中文摘要:
      目的:评价急性心肌梗死(acute myocardial infarction,AMI)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者直接经皮冠脉介入治疗术后近期与远期主要不良心血管事件(major adverse cardiovascular events,MACE)的发生情况。方法:纳入2011年9月—2015年6月在苏州市立医院北区行直接经皮冠脉介入治疗的AMI患者230例,按照是否合并T2DM分为AMI+T2DM组103例、单纯AMI组127例。比较两组患者的手术成功率、术后30 d和3年的MACE(包括心源性死亡、心力衰竭、靶血管血运重建、支架内血栓)。结果:AMI+T2DM组和单纯AMI组的手术成功率分别为97.6%和99.0%,差异无统计学意义(P > 0.05)。术后30 d,AMI+T2DM组心力衰竭发生率明显高于单纯AMI组(10.67% vs. 3.14%,P=0.03);支架内血栓和靶血管血运重建事件两组间差异均无统计学意义(1.94% vs. 0.79%,4.85% vs. 3.15%,P均> 0.05)。术后3年,AMI+T2DM组的心源性死亡、靶血管血运重建、心力衰竭的发生率明显高于单纯AMI组,差异有统计学意义(8.93% vs. 2.36%,P=0.032;6.79% vs. 0.79%,P=0.024;14.56% vs. 4.72%,P=0.012)。结论:AMI合并T2DM患者,远期靶血管血运重建率明显高于不合并T2DM的患者;心力衰竭的发生率不论近期还是远期均明显高于不合并T2DM的患者。
英文摘要:
      Objective:To explore the incidence of major adverse cardiovascular events(MACE)in acute myocardial infarction(AMI)patients with type 2 diabetes mellitus(T2DM)after primary percutaneous coronary intervention(PCI). Methods:A total of 230 AMI patients who received primary PCI were included in our hospital from September,2011 to June,2015. The patients were divided into two groups:the AMI+T2DM group(n=103)and the AMI group(n=127). The clinical characteristics,coronary angiographic features,PCI outcomes,and incidence of major adverse cardiovascular events(MACE)including cardiac death,heart failure,target vessel revascularization and thrombosis within the stent at 30 days and 3 years were compared. Results:There was no difference in acute successful rate of intervention between the two groups. At 30 days after PCI,the incidence of heart failure was higher in the AMI+T2DM group than that in the AMI group(10.67% vs. 3.14%,P=0.03). However,no significant differences in rate of thrombosis within stent and target vessel revascularization(TVR)were observed(1.94% vs. 0.79%,4.85% vs. 3.15%,respectively,both P > 0.05). During 3?year follow up period,the incidences of cardiac death,TVR and heart failure were significantly higher in AMI patients with T2DM than without T2DM patients(8.93% vs. 2.36%,P=0.032;6.79% vs. 0.79%,P=0.024;14.56% vs. 4.72%,P=0.012,respectively). Conclusion:Compared to AMI patients without T2DM,the incidence of TVR was significantly higher during long?term follow up and the incidence of heart failure was significantly higher during both short? and long?term follow up in AMI patients with T2DM.
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