| Objective:Coronary heart disease(coronary atherosclerotic heart disease)refers to coronary artery atherosclerosis caused by lumen stenosis or occlusion,leading to myocardial ischemia and hypoxia caused by heart disease,is a relatively common cardiovascular Diseases,with high morbidity and mortality,have a serious impact on the lives of patients.Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia caused by multiple etiologies.It is also a risk factor for coronary heart disease and increases the incidence of coronary heart disease.The treatment of patients with diabetes mellitus complicated with coronary heart disease is mostly drug therapy,but the effect of simple drugs on the improvement of the patient's heart function is poor.Interventional treatment has good clinical effect in the treatment of coronary heart disease,but there are few studies on the change of heart function in patients with coronary heart disease with or without diabetes,and whether interventional treatment affects the patient's heart function.Therefore,this study The effect of interventional treatment on heart function in patients with diabetes mellitus complicated with coronary heart disease was discussed.Methods:164 patients with coronary artery disease were selected from March 2014 to August 2014 in a Third people's Hospital of Huizhou.The clinical data were analyzed retrospectively.All patients were divided into four groups according to whether the patients had diabetes mellitus and treatment methods.Group(42diabetic patients with coronary heart disease,drug therapy + interventional treatment),study 2 groups(42 diabetic patients with coronary heart disease,drug treatment),control group 1(40 patients with coronary heart disease,drug therapy + interventional treatment),control 2 Group(40 patients with coronary heart disease,medication),observed coronary artery disease before and after treatment(coronary stenosis score),cardiac function(diastolic ventricular septal thickness IVST,left ventricular end diastolic diameter LVDD,left ventricular ejection fraction LVEF and left ventricular end-systolic diameter(LVSD)were recorded after 1 year of treatment in both groups.All patients were followed up for 3 years to evaluate their 3-year prognosis(cardiac adverse events)and data were obtained.SPSS20.0 statistical software was used for analysis.Results:(1)In this study,164 patients with coronary heart disease were selected and divided into 4 groups according to whether they were complicated with diabetes and treatment methods.A group of 42 patients with coronary heart disease and diabetes mellitus were treated with drug + interventional therapy,23 males.19 women(mean age,60.2±5.1 years);study group 2 patients with coronary heart disease and diabetes mellitus,drug treatment,19 males and 23 females,mean age(59.1±4.5)years;control group 1 was simple crown Cardiac disease patients were treated with drug plus interventional therapy.There were 21 males and 19 females with an average age of(59.3±4.9)years.The control group 2 was a simple coronary heart disease patient and was treated with drugs.There were 20 males and 20 females.The average age was 60.7 ± 5.3)years old.The general data of the four groups of patients are shown in Table 3-1.After statistical software processing,the difference was not statistically significant(P>0.05).(2)Coronary lesion stenosis score: Before therapy,the four groups of coronary artery lesion stenosis scores were:(24.6±2.5)points,(23.8±3.1)points,(24.1±2.7)points,(23.6±3.6))scores,there was no significant difference between the groups(P> 0.05);after treatment,The scores of coronary lesions after treatment in the four groups(7.9±1.5 points,22.6±2.6 points,6.7±1.3 points,21.7±1.7 points)were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).After treatment,The severity score of coronary artery lesions in study group 1 was lower than that in study 2.In the group,the difference was statistically significant(t=31.738,P<0.05);in the control group 1,the coronary lesion stenosis score was lower than that in the control group 2,and the difference was statistically significant(t=44.329,P<0.05).and the study group 1 The stenosis scores of coronary artery lesions were significantly higher than those of the control group(t=3.863,P<0.05).(3)Therapeutic effect:After treatment,the total effective rate of treatment in group 1 was 92.9%,which was significantly higher than that of group 2(69.0%).The difference was statistically significant(P<0.05);the total effective rate of group 1was 95.0%.It was significantly higher than 72.5%in the control group 2.The difference was statistically significant(P<0.05).There was no significant difference in the total effective rate between the study 1 and control 1 groups(P>0.05).There was no significant difference in the total effective rate between the study group 2 and the control group 2(P>0.05).(4)Cardiac function index: Before treatment,the IVST,LVDD,LVSD,and LVEF levels of the four groups of patients were not statistically different(P>0.05).After treatment,the cardiac function index of the four groups was better than before treatment.The IVST,LVDD,and LVSD levels were lower than those in the control group.The LVEF levels were higher than those in the control group(P<0.05).The IVST,LVDD,and LVSD levels in the study group 1 were lower than those in the study group 2,and the LVEF levels were higher than those in the study group.The difference between the two groups was statistically significant(P<0.05).The IVST,LVDD,and LVSD levels in study group 1 were higher than those in control group 1,and the LVEF levels were lower in the control group than in the control group(P<0.05).(5)Long-term prognosis:The total incidence of death,non-fatal myocardial infarction,revascularization in the study group was 32.14%(27/84),and the total incidence of the above events in the control group was 16.3%(13/80);The total incidence of these events was higher in the group than in the control group,with a statistically significant difference(P<0.05).In the study group,the total incidence of21.4%in the study group 1 was lower than that in the study group 2(42.9%),and the difference was statistically significant(P < 0.05).In the control group,the total occurrence rate of 5.0%of the above events in the control group 1 was lower than that of the control group 2(27.5%),and the difference was statistically significant(P<0.05).The total incidence of these events in patients undergoing interventional therapy was 13.4%(11/82).The total incidence of these events in drug-treated patients was 35.4%(29/82).The total incidence of these events in interventional patients was lower than that of drug therapy,and the difference was statistical.Significance(P < 0.05).Among the interventional patients,the total occurrence rate of the above events in the study group 1 was 21.4%higher than that of the control group 1.0%,with a statistically significant difference(P<0.05).Conclusion:Diabetes mellitus increases the incidence of adverse cardiovascular events in patients with coronary interventional therapy and affects the prognosis of patients;interventional therapy and drug treatment can improve the heart function in patients with coronary heart disease,but the improvement effect of interventional treatment is more obvious.Recommendation: For patients with coronary heart disease,in addition to the need to determine whether the patient is associated with diabetes,it is recommended to use interventional therapy to improve the patient's heart function and prognosis. |
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