朱伯达,禹天同,韩鹏,张博辉,张玺,袁平,王刚,杨易,朱惠莉,孙盼盼,李彤彤,赵帅,李成祥,廉坤

• 1:中国人民解放军空军军医大学第一附属医院心血管内科
• 2:空军航空大学初级飞行训练基地
• 3:中国人民解放军联勤保障部队第九八一医院心内科
• 4:中国人民解放军空军军医大学第二附属医院全科医学科

摘要(Abstract)：

目的 本研究旨在评估成功的经皮冠状动脉介入治疗（PCI）能否改善合并糖尿病的左主干病变和（或）三支血管病变患者的症状和生活质量。方法 连续纳入2018年4月1日至2021年5月31日在中国人民解放军空军军医大学第一附属医院行PCI的左主干病变和（或）三支血管病变患者，并将其分为糖尿病组和非糖尿病组。收集患者的基线资料、呼吸困难和心绞痛症状以及生活质量[分别采用Rose呼吸困难量表（RDS）和西雅图心绞痛量表（SAQ）、生命质量SF-12量表、欧洲五维健康量表（EQ-5D）评估]、手术资料以及1个月和1年随访资料。结果 在440例左主干病变和（或）三支血管病变患者中，糖尿病组患者176例（40.00%），其高血压病、外周动脉疾病和左回旋支病变比例较高而左心室射血分数较低（均P<0.05）。在1个月随访时，两组的主要不良心血管事件（MACE）和全因死亡率相似（均P>0.05），而在1年随访时，糖尿病组患者的全因死亡率明显高于非糖尿病组患者（P=0.013）。低左心室射血分数是成功血运重建1个月和1年内MACE和全因死亡的独立危险因素（均P<0.05）。最重要的是，无论是否患有糖尿病，在1个月和1年随访时，症状包括呼吸困难和心绞痛以及生活质量都有显著改善（均P<0.05）。糖尿病组患者显示出与非糖尿病组患者相似的呼吸困难和生活质量改善程度（均P>0.05），并且心绞痛缓解更为显著（P=0.013）。此外，每位患者的冠状动脉慢性完全闭塞病变数量是呼吸困难（OR 0.723,95%CI 0.525～0.997,P=0.048）和心绞痛缓解（OR 0.686,95%CI 0.473～0.995,P=0.047）的独立危险因素，而对比剂用量（OR 0.995,95%CI0.992～0.999,P=0.008）则是糖尿病患者生活质量改善的独立危险因素。结论 成功PCI对于缓解症状和提高生活质量有益，适用于患有糖尿病的左主干病变和（或）三支血管病变患者。

关键词(KeyWords)： 左主干病变;三支血管病变;糖尿病;症状;生活质量

Abstract:

Keywords:

基金项目(Foundation): 西京医院医务人员培养助推项目（XJZT24LY39）;; 空军军医大学临床研究项目（2022LC2208）;; 陕西省重点研发计划重点产业创新链项目（2024SF-YBXM-004）;陕西省重点研发计划一般项目（2024GXYBXM-136）

作者(Author): 朱伯达,禹天同,韩鹏,张博辉,张玺,袁平,王刚,杨易,朱惠莉,孙盼盼,李彤彤,赵帅,李成祥,廉坤

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