Herlitz J, Haglid M, Hartford M, Karlson B W, Karlsson T, Lindelöw B, Caidahl K
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Diabetes Care. 1998 Oct;21(10):1603-11. doi: 10.2337/diacare.21.10.1603.
To describe the limitation of physical activity and symptoms of chest pain and dyspnea before and after coronary artery bypass grafting (CABG) in relation to a history of diabetes.
All patients in western Sweden in whom CABG was performed between 1988 and 1991 were asked to complete a questionnaire before 3 months and 2 years after the operation. The questionnaire evaluated limitation of physical activity and symptoms of chest pain and dyspnea.
In all, 2,121 patients participated in the evaluation, of whom 13% had a history of diabetes. The overall 2-year mortality was 14% among patients with a history of diabetes and 6% among patients without such a history (P < 0.001). The proportion of patients with a limitation of physical activity caused by chest pain decreased from 76% before CABG to 19% 2 years after in diabetic patients (P < 0.001) and from 79 to 17% in nondiabetic patients (P < 0.001). The proportion of diabetic patients without dyspnea increased from 13% before to 31% 2 years after CABG (P < 0.001). The corresponding figures for nondiabetic patients were 12 and 43% (P < 0.001). Symptoms of angina pectoris were reported in 94% of diabetic patients before CABG versus 35% after 2 years (P < 0.001). Corresponding figures for nondiabetic patients were 93 and 29% (P < 0.001). Aggregate data confirmed differences between diabetic and nondiabetic patients, with more symptoms in the diabetic patients, particularly with regard to dyspnea.
Mortality during 2 years of follow up was more than twice as high in diabetic than in nondiabetic patients. Limitation of physical activity, dyspnea, and angina pectoris improved markedly and similarly in diabetic and nondiabetic patients after CABG. Whereas limitation of physical activity and dyspnea was more frequent in diabetic than in nondiabetic patients, the occurrence of angina pectoris was more similar in the two groups.
描述冠状动脉旁路移植术（CABG）前后与糖尿病病史相关的身体活动受限情况以及胸痛和呼吸困难症状。
瑞典西部所有在1988年至1991年间接受CABG手术的患者被要求在术后3个月和2年之前填写一份问卷。该问卷评估身体活动受限情况以及胸痛和呼吸困难症状。
共有2121名患者参与评估，其中13%有糖尿病病史。有糖尿病病史的患者总体2年死亡率为14%，无糖尿病病史的患者为6%（P<0.001）。糖尿病患者中因胸痛导致身体活动受限的比例从CABG术前的76%降至术后2年的19%（P<0.001），非糖尿病患者从79%降至17%（P<0.001）。无呼吸困难的糖尿病患者比例从术前的13%升至CABG术后2年的31%（P<0.001）。非糖尿病患者的相应数字为12%和43%（P<0.001）。CABG术前94%的糖尿病患者报告有胸痛症状，2年后为35%（P<0.001）。非糖尿病患者的相应数字为93%和29%（P<0.001）。汇总数据证实糖尿病患者和非糖尿病患者之间存在差异，糖尿病患者症状更多，尤其是呼吸困难方面。
随访2年期间，糖尿病患者的死亡率是非糖尿病患者的两倍多。CABG术后，糖尿病患者和非糖尿病患者的身体活动受限、呼吸困难和胸痛症状均有明显且相似的改善。虽然糖尿病患者身体活动受限和呼吸困难比非糖尿病患者更频繁，但两组胸痛的发生率更相似。
