Järvinen Otso, Julkunen Juhani, Saarinen Timo, Laurikka Jari, Tarkka Matti R
Heart Center, Department of Cardiac Surgery, Tampere University Hospital, Tampere, Finland.
Ann Thorac Surg. 2005 Mar;79(3):819-24. doi: 10.1016/j.athoracsur.2004.08.030.
An increasing proportion of patients undergoing coronary artery bypass grafting are diabetics who are known to carry a higher mortality and morbidity in association with operation, but data on whether health-related quality of life improves similarly after coronary artery bypass grafting in diabetic and nondiabetic patients are limited. We assessed in detail changes in health-related quality of life (RAND-36 Health Survey) during the first year after coronary artery bypass grafting.
Seventy-four of the 508 patients (14.6%) operated on in a single institution had a history of diabetes and were compared to nondiabetics. The RAND-36 Health Survey was used as an indicator of quality of life. Assessments were made preoperatively and repeated 12 months later.
Thirty-day mortality was 2.7% versus 1.6% (p = 0.511) and one-year survival was 94.6% versus 97.0% (p = 0.287) in the diabetics and nondiabetics, respectively. Diabetics improved significantly (p < 0.005) in seven, nondiabetics (p < 0.001) in all eight RAND-36 dimensions. Physical component summary and mental component summary scores on the RAND-36 improved significantly (p < 0.001) in diabetics as well as in nondiabetics. Both groups experienced closely similar freedom from anginal symptoms at one year (86.2% vs 90.5%, p = 0.280).
Although diabetic patients differ from nondiabetics having slightly inferior quality of life before and one year after coronary artery bypass grafting, they gain similar improvement of quality of life in one year after surgery when compared to nondiabetics.
接受冠状动脉旁路移植术的患者中糖尿病患者的比例日益增加，已知这类患者手术相关的死亡率和发病率更高，但关于糖尿病患者和非糖尿病患者冠状动脉旁路移植术后健康相关生活质量改善情况是否相似的数据有限。我们详细评估了冠状动脉旁路移植术后第一年健康相关生活质量（兰德36健康调查）的变化。
在一家机构接受手术的508例患者中有74例（14.6%）有糖尿病史，并与非糖尿病患者进行比较。使用兰德36健康调查作为生活质量指标。术前进行评估，并在12个月后重复评估。
糖尿病患者和非糖尿病患者的30天死亡率分别为2.7%和1.6%（p = 0.511），1年生存率分别为94.6%和97.0%（p = 0.287）。在兰德36的八个维度中，糖尿病患者有七个维度显著改善（p < 0.005），非糖尿病患者所有八个维度均显著改善（p < 0.001）。糖尿病患者和非糖尿病患者的兰德36身体成分汇总得分和精神成分汇总得分均显著改善（p < 0.001）。两组在术后一年时心绞痛症状缓解情况相近（86.2%对90.5%，p = 0.280）。
尽管糖尿病患者与非糖尿病患者相比，冠状动脉旁路移植术前和术后一年的生活质量略低，但与非糖尿病患者相比，他们术后一年的生活质量改善程度相似。
