Аннотация
В настоящее время сахарный диабет (СД) признан эквивалентом ишемической болезни сердца
(ИБС), а также отнесен к факторам самой высокой степени риска развития ИБС. Известно, что
коронарный атеросклероз имеет более тяжелые последствия при наличии у больного СД, так как
сочетание этих двух факторов значительно увеличивает риск развития более ранних и острых
проявлений ИБС, часто сочетающихся с поражением ствола левой коронарной артерии,
окклюзионным, многососудистым и диффузным поражением коронарного русла. В связи с этим
все большее число больных становятся кандидатами на проведение реваскуляризации миокарда.
Несмотря на значительные достижения в эндоваскулярной хирургии, результаты коронарного
стентирования у больных СД остаются хуже, чем у больных ИБС без диабета. Результаты
крупномасштабных исследований свидетельствуют о несомненных преимуществах проведения
аортокоронарного шунтирования (АКШ) у больных СД при характерном для них многососудистом
поражении коронарных артерий. Также показано, что широкое применение артериальных
кондуитов (левой и правой внутренней грудной артерии и лучевой артерии) при выполнении АКШ
способствует улучшению прогноза в аспекте снижения отдаленной смертности и риска развития
основных кардиоваскулярных осложнений.
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Об авторах
- Керен Милена Абрековна, доктор мед. наук, научн. сотр.
- Ярбеков Рустам Раимкулович, канд. мед. наук
