Kyriakides Z S, Psychari S, Chrysomallis N, Georgiadis M, Sbarouni E, Kremastinos D T
Second Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece.
Heart. 2002 Jan;87(1):61-6. doi: 10.1136/heart.87.1.61.
To test whether type II diabetes prevents the recruitment of collaterals and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty.
Two groups of patients were studied. A collateral circulation group consisted of 56 patients, 18 diabetic and 38 non-diabetic. All underwent a minimum of three balloon inflations. A pressure guide wire was used for the measurement of coronary wedge pressure (mm Hg). The angioplasty protocol was repeated in another group of 57 patients (myocardial ischaemia group) using both surface and intracoronary ECGs to assess myocardial ischaemia.
In diabetic patients, mean (SD) coronary wedge pressure was 35 (12) mm Hg during the first balloon inflation, 39 (15) mm Hg during the second (p < 0.05 v first inflation), and 42 (17) mm Hg during the third (p < 0.05 v first inflation); in non-diabetic patients the respective values were 36 (16), 37 (16), and 37 (16) mm Hg (F = 4.73, p = 0.01). The ratio of coronary wedge pressure to mean arterial pressure in diabetic patients in the three balloon inflations was 0.33 (0.11), 0.36 (0.13), and 0.39 (0.15), respectively (p < 0.05 v the first inflation); and in non-diabetic patients it was 0.33 (0.15), 0.34 (0.15), and 0.35 (0.15) (F = 1.92, p = 0.15). In the diabetic group the response was independent of the type of treatment. No difference between diabetic and non-diabetic patients was observed in the normal reduction of myocardial ischaemia on repeated balloon inflations.
Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty in single vessel disease, regardless of the type of antidiabetic treatment.
检测2型糖尿病是否会在冠状动脉血管成形术期间阻止侧支循环的募集以及重复球囊扩张时心肌缺血的正常减轻。
对两组患者进行研究。侧支循环组由56例患者组成，其中18例糖尿病患者和38例非糖尿病患者。所有患者至少接受三次球囊扩张。使用压力导丝测量冠状动脉楔压（毫米汞柱）。另一组57例患者（心肌缺血组）采用体表和冠状动脉内心电图评估心肌缺血，重复血管成形术方案。
糖尿病患者中，首次球囊扩张时平均（标准差）冠状动脉楔压为35（12）毫米汞柱，第二次为39（15）毫米汞柱（与首次扩张相比，p<0.05），第三次为42（17）毫米汞柱（与首次扩张相比，p<0.05）；非糖尿病患者相应的值分别为36（16）、37（16）和37（16）毫米汞柱（F=4.73，p=0.01）。糖尿病患者在三次球囊扩张时冠状动脉楔压与平均动脉压的比值分别为0.33（0.11）、0.36（0.13）和0.39（0.15）（与首次扩张相比，p<0.05）；非糖尿病患者该比值分别为0.33（0.15）、0.34（0.15）和0.35（0.15）（F=1.92，p=0.15）。在糖尿病组中，反应与治疗类型无关。在重复球囊扩张时，糖尿病患者和非糖尿病患者在心肌缺血正常减轻方面未观察到差异。
在单支血管疾病的冠状动脉血管成形术期间，无论抗糖尿病治疗类型如何，2型糖尿病均不会阻止侧支血管的募集以及重复球囊扩张时心肌缺血的正常减轻。
