Kawasuji M, Sakakibara N, Takahashi M, Tedoriya T, Ueyama K, Misaki T, Watanabe Y
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):990-2.
To determine the influence of diabetes mellitus on the results of coronary artery bypass surgery, a review of 163 diabetic patients operated on during 8 years, of whom 146 were receiving no drugs or receiving oral hypoglycemic agents, and 17 were receiving insulin. They were compared with 337 nondiabetic patients operated on over the same period. Higher incidences of hypertension and cerebrovascular disease for the diabetic group were found. The extent of coronary artery disease as judged angiographically was significantly greater in the diabetic group than in the nondiabetic group. Perioperative mortality was similar in the two groups. The incidence of perioperative myocardial infarction, sternotomy complication, neurological complication, and renal insufficiency was equal in the two groups. Early graft patency was comparable in the two groups. Overall 8-year actuarial angina free ratios were 88.5% for the diabetic group, 93.2% for the nondiabetic group. Overall 8-year survival rates were 95.6% for the diabetic group, 98.6% for the nondiabetic group. Results indicate that diabetic patients have quantitatively more coronary artery disease than the non-diabetic patients but have no higher perioperative morbidity and mortality than nondiabetic patients. Long-term results revealed a lower angina free rate in diabetic patients than in nondiabetic patients.
为确定糖尿病对冠状动脉搭桥手术结果的影响，回顾了8年间接受手术的163例糖尿病患者，其中146例未用药或服用口服降糖药，17例接受胰岛素治疗。将他们与同期接受手术的337例非糖尿病患者进行比较。发现糖尿病组高血压和脑血管疾病的发生率更高。血管造影显示糖尿病组冠状动脉疾病的程度明显高于非糖尿病组。两组围手术期死亡率相似。两组围手术期心肌梗死、胸骨切开术并发症、神经并发症和肾功能不全的发生率相等。两组早期移植物通畅率相当。糖尿病组8年总体无心绞痛 actuarial 比率为88.5%，非糖尿病组为93.2%。糖尿病组8年总体生存率为95.6%，非糖尿病组为98.6%。结果表明，糖尿病患者的冠状动脉疾病在数量上比非糖尿病患者多，但围手术期发病率和死亡率并不高于非糖尿病患者。长期结果显示，糖尿病患者的无心绞痛率低于非糖尿病患者。
