2018 年第 5 期 第 13 卷

冠状动脉粥样硬化性心脏病合并糖尿病患者冠状动脉旁路移植术后远期疗效的临床研究

Long-term efficacy of coronary artery bypass grafting in coronary atherosclerotic heart disease patients with diabetes mellitus

作者：杨海平郝懿陈林张振华贺宁陈越岭王晶

英文作者：

单位：101100首都医科大学附属北京潞河医院胸心外科

英文单位：

关键词：冠状动脉粥样硬化性心脏病;糖尿病;冠状动脉CT血管造影;桥血管;通畅率

英文关键词：

• 摘要：

• 目的    观察冠状动脉粥样硬化性心脏病合并糖尿病患者冠状动脉旁路移植术（CABG）后的远期疗效。方法    选取2009年1月至2010年12月于首都医科大学附属北京潞河医院因冠状动脉粥样硬化性心脏病行CABG术后患者66例，根据是否合并糖尿病分为糖尿病组（27例）与非糖尿病组（39例），术后5年行冠状动脉CT检查桥血管通畅率。结果    2组患者性别、年龄、左心室射血分数、术后并发症等资料比较差异均无统计学意义（均P＞0.05）。66例患者共检测141根桥血管（其中糖尿病组60根，非糖尿病组81根），糖尿病组患者桥血管闭塞率高于，通畅率低于非糖尿病组［38.3%(23/60)比21.0%（17/81）,26.7%（16/60）比51.9%（42/81）］，差异均有统计学意义(χ2=5.103、4.804，P=0.024、0.028)。结论    冠状动脉粥样硬化性心脏病合并糖尿病患者行CABG术后桥血管闭塞及狭窄的发生率高于非糖尿病患者，临床需加强对此类患者的随访，及时采取有效干预措施。

• 【Abstract】Objective    To investigate the long-term effect of coronary artery bypass graft（CABG） on coronary atherosclerotic heart disease (CHD) patients with diabetes mellitus. Methods    ixty-six CHD patients undergoing CABG from January 2009 to December 2010 in Beijing Luhe Hospital, Capital Medical University were divided into diabetic group（n＝27） and non-diabetic group（n＝39）. The patency rate of bypass graft was examined by coronary computed tomography angiography(CTA) 5 years after operation. Results    There were no statistical differences of sex, age, left ventricular ejection fraction and postoperative complication between groups（P＞0.05）. One hundred and forty-one grafts（60 grafts in diabetic group and 81 grafts in non-diabetic group） were examined by CTA; the occlusion rate in diabetic group was significantly higher and the patency rate was significantly lower than those in non-diabetic group［38.3%(23/60) vs 21.0%（17/81）, 26.7%（16/60） vs 51.9%（42/81）］(χ2=5.103, 4.804; P=0.024, 0.028). Conclusion    CHD complicated with diabetes patients have high risks of graft occlusion and stenosis after GABG.

  【Key words】Coronary atherosclerotic heart disease;Diabetes mellitus;Coronary CT angiography;Bypass artery;Patency rate

  【Fund program】Beijing Tongzhou District Science and Technology Project（KJ2016CX037-21）