Devineni R, McKenzie F N
Can J Surg. 1985 Jul;28(4):367-70.
The results of surgery for occlusive coronary artery disease were studied in 600 consecutive, unselected patients who underwent aortocoronary bypass grafting between Jan. 1, 1977 and Dec. 31, 1982. Forty (7%) of these patients had diabetes mellitus, requiring medication. Sixteen of the 40 patients were insulin-dependent, the remainder required oral hypoglycemic agents. The frequency of previous myocardial infarction, hypertension and peripheral vascular disease in the groups of nondiabetic and diabetic patients was 38% and 62.5%, 12% and 22.5%, and 10.5% and 25% respectively. There was no significant difference in the rate of unstable angina, triple-vessel disease, emergency surgery, left ventricular dysfunction, myocardial infarction perioperatively and hospital morbidity or mortality in the two groups. On coronary angiography, 82% of coronary arteries in diabetic patients were graded as being small or moderate in size (less than 2 mm in diameter); at operation, 62% of these arteries were found to be 2 mm or more in diameter. At a mean follow-up of 3.9 years and 3.7 years in the nondiabetic and diabetic patients respectively (range from 1 to 6 years), no significant difference was noted with regard to relief of symptoms or survival in the two groups. It is concluded that diabetic patients with coronary artery disease can be offered bypass surgery with good short-term and medium-term results.
对1977年1月1日至1982年12月31日期间连续600例未经挑选、接受主动脉冠状动脉搭桥术的闭塞性冠状动脉疾病患者的手术结果进行了研究。这些患者中有40例（7%）患有糖尿病，需要药物治疗。40例患者中有16例依赖胰岛素，其余患者需要口服降糖药。非糖尿病患者组和糖尿病患者组既往心肌梗死、高血压和外周血管疾病的发生率分别为38%和62.5%、12%和22.5%、10.5%和25%。两组在不稳定型心绞痛发生率、三支血管病变、急诊手术、左心室功能障碍、围手术期心肌梗死以及医院发病率或死亡率方面无显著差异。冠状动脉造影显示，糖尿病患者中82%的冠状动脉直径分级为小或中等（直径小于2毫米）；手术时发现其中62%的动脉直径为2毫米或更大。非糖尿病患者和糖尿病患者的平均随访时间分别为3.9年和3.7年（范围为1至6年），两组在症状缓解或生存率方面无显著差异。结论是，患有冠状动脉疾病的糖尿病患者可以接受搭桥手术，短期和中期效果良好。
