摘要
目的旨在研究糖尿病胰岛素使用对复杂多支病变冠心病患者冠状动脉旁路移植术(CABG)后早期预后的影响。方法本研究纳入广西医科大学第一附属医院2013年1月至2016年5月78例复杂病变冠心病合并糖尿病患者,均接受冠状动脉旁路移植术(coronary artery bypass graft,CABG)治疗,55例(70.5%)为非胰岛素治疗的糖尿病患者,23例(29.5%)为使用胰岛素治疗的糖尿病患者,两组患者均采用乳内动脉+桡动脉全动脉旁路方式,采用非体外循环旁路移植术式。平均随访时间2年。结果两组患者病死率(P=0.829)和心血管事件发生率比较未见统计学差异(P=0.434),5例(6.4%)患者术后发生心肌梗死的并发症,3例(3.8%)患者监护期间出现脑梗塞。19例(24.3%)患者随访期间复查冠状动脉造影,其中2例(2.5%)患者的造影结果提示移植血管的功能病变,两组之间移植血管病变之间无明显差异。结论糖尿病患者胰岛素的使用对多支病变CABG患者的早期预后元显著不利影响,且对于复杂多支病变合并糖尿病的患者有积极的治疗作用。
Objective To investigate the effect of insulin use on the early prognosis of patients with complex multivessel CHD disease after CABG.Methods In the first affiliated Hospital of Guangxi Medical University from January 2013 to May 2016,a total of 78 patients with complicated coronary heart disease complicated with diabetes mellitus underwent CABG surgery.55 (70.5%)patients were non-insulin treated diabetic patients.23 (29.5%)patients were diabetic patients treated with insulin.The patients in both groups were treated with internal mammary artery combined with radial artery bypass grafting and off-pump bypass grafting. The mean follow-up time was 23 months.Results There was no significant difference in mortality (P=0.829) and incidence of cardiovascular events (P=0.434)between the two groups.5 (6.4%)patients had complications of myocardial infarction after operation.3 (3.8%)patients had cerebral infarction during monitoring,19 (24.3%) patients had coronary angiography during follow-up,among which 2 (2.5%)patients showed functional lesion of grafts;there was no significant difference between the two groups.Conclusion Insulin use in diabetic patients has no significant side effect on the early prognosis of patients with multiple vessel disease underwent CABG. Insulin use still has a positive therapeutic effect on the patients with complicated multi-vessel disease and diabetes mellitus.
作者
陈冲
郑宝石
陈绪军
雷宾峰
谢晓勇
罗程
黎玉贵
蔡雄伟
CHEN Chong;ZHENG Bao-shi;CHEN Xu-jun;LEI Bin-feng;XIE Xiao-yong;LUO Cheng;LI Yu-gui;CAI Xiong-wei(Department of Cardiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530000,China)
出处
《中国心血管病研究》
CAS
2019年第1期48-51,共4页
Chinese Journal of Cardiovascular Research
基金
广西壮族自治区科学技术重点研发计划(AB18126057).
关键词
冠状动脉旁路移植术
糖尿病
病死率
胰岛素
Coronary artery bypass graft(CABG)
Diabetes mellitus
Mortality
Insulin
作者简介
通信作者:郑宝石,E-mail:zhengbs25@vip.sina.com.
