2型糖尿病患者的冠状动脉造影和主动脉-冠状动脉搭桥手术。

Diabete & metabolisme Pub Date : 1995-12-01
E Faglia, F Favales, M Brivio, G L Pizzi, L Campolo, G Cataldo, S Pirelli, A Pellegrini, C Taglieri, A Caroli
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引用次数: 0

摘要

本文分析了2型糖尿病心绞痛患者与非糖尿病心绞痛患者进行血管造影并随后进行手术或药物治疗并随访5年的情况,以评估与非糖尿病患者相比,2型糖尿病心绞痛患者的冠状动脉造影结果、冠状动脉搭桥术的疗效和预后标准。共有1853名非糖尿病患者和145名糖尿病患者接受了血管造影,其中分别有857名和68名接受了手术。测量围手术期死亡率、生存率、再梗死率和无症状率。对危险因素和临床特征进行多因素分析。糖尿病患者多支血管狭窄发生率高(p < 0.001),血管狭窄弥散度高(p < 0.005),左心室运动差(p < 0.005)。围手术期梗死和死亡率无差异。与未手术组相比,手术组患者生存率更高(p < 0.001),无症状期更长(p < 0.05)。手术后糖尿病患者与非糖尿病患者生存率相近,心绞痛复发率较高(p < 0.05)。未手术的糖尿病患者生存率低于未手术的非糖尿病患者(p < 0.05)。心绞痛复发相似。多变量分析未显示糖尿病是影响生存的因素。结论:对于合并冠心病的2型糖尿病患者,手术是一种合适的治疗选择,无论是否患有糖尿病,手术都能降低死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coronary angiography and aorto-coronary bypass surgery in type 2 diabetic patients.

Diabetic and non-diabetic subjects with angina who underwent angiography and were subsequently treated surgically or medically and followed up for 5 years were analysed in order to assess coronary angiographic findings, efficacy of coronary artery bypass grafting and prognostic criteria in Type 2 diabetic patients with angina as compared to non-diabetic subjects. A total of 1853 of non-diabetic and 145 diabetic subjects underwent angiography, including respectively 857 and 68 who had surgery. Perioperative mortality, survival, reinfarction and asymptomaticity rates were measured. Multivariate analysis of risk factors and clinical features was performed. Diabetic patients had a higher frequency of multi-vessel stenoses (p < 0.001), a greater diffusion of stenoses (p < 0.005) and worse left ventricular motion (p < 0.005). No differences were found in perioperative infarction and mortality. Operated diabetic patients had a higher survival rate (p < 0.001) and a longer symptom-free period (p < 0.05) than unoperated diabetic patients. Operated diabetic patients had similar survival and more frequent recurrence of angina (p < 0.05) than operated non-diabetic patients. Survival rate was lower for unoperated diabetic patients than unoperated non-diabetic patients (p < 0.05). Recurrence of angina was similar. Multivariate analysis did not indicate diabetes as a factor affecting survival. It is concluded that surgery for Type 2 diabetic patients with coronary artery disease is a suitable therapeutic option conferring a reduction in mortality regardless of the presence of diabetes.

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