PCI治疗糖尿病患者左主干病变的临床研究

目的：研究经皮冠状动脉介入术（percutaneous coronary intervention，PCI）治疗合并冠状动脉左主干病变糖尿病患者的临床特 征及预后。方法：回顾性分析首次冠脉造影并提示冠状动脉左主干病变接受PCI治疗患者共2350 人，其中2 型糖尿病患者692 人，非糖尿病患者1658 人。比较两组患者的基本临床特征、冠脉造影及介入特点、随访结果等。结果：基线资料中糖尿病组患者的 高血压比例、高血脂比例、脑血管病比例、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）与血肌酐（creatinine， Crea）值明显高于非糖尿病组，在造影及PCI资料中糖尿病患者左主干体部病变和全程病变明显高于非糖尿病患者，左主干病变 完全血运重建率以及药物洗脱支架（Drug eluting stent，DES）使用率明显低于非糖尿病组。糖尿病组患者主要心血管不良事件 （Major adverse cardiac events，MACE）发生率和全因死亡显著增高（13%vs 10%，P<0.05；7.7%vs 5.5%，P<0.05）。结论：PCI 治疗 合并糖尿病冠状动脉左主干病变患者存在可能的临床不良事件率增加的风险。

Clinical Study of Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease in Diabetes

Objective:To investigate clinical characteristics and long-term outcome of left main coronary PCI in diabetes.Methods:We had retrospectively analyzed 2350 patients. 692 patients with diabetes and 1658 patients with non-diabetes. Baseline characteristics, angiographic characteristics, PCI characteristics and follow up outcomes were studied.Results:Ratio of hypertension, hyperlipemia, cerebrovascular disease, shaft lesion, ostiumto distal lesion were higher in diabetes. Value of HDL-C and Crea were higher in diabetes. Complete revascularization and DES ratio were lower in diabetes. MACE and all cause death were higher in diabetes(13%vs 10%, P<0.05; 7.7% vs 5.5%, P<0.05).Conclusion:Diabetes may increase adverse clinical risk in left main disease patients undergoing PCI.