替罗非班对老年急性冠状动脉综合征介入治疗后血清可溶性CD40配体的影响

目的观察替罗非班在老年非ST段抬高急性冠状动脉综合征（NSTEACS）介入治疗（PCI）的疗效及对血清可溶性CD40配体（sCD40L）水平的影响。方法将80例经危险度分层为高危的老年NSTEACS患者行介入治疗,随机分为替罗非班组43例,对照组37例,观察住院期间及术后30d内的主要心血管事件（MACE）,用酶联免疫吸附法（ELISA）法测定所有入选患者PCI前后血清sCD40L水平。结果与对照组相比,替罗非班组住院期间及术后30d内MACE发生率有所降低（9.5%比18.9%,P〉0.05） 两组大出血发生率均为0,差异无统计学意义 替罗非班组轻度出血（10/43）较对照组（7/37）有所增加,但差异无统计学意义（P〉0.05） 替罗非班组治疗后血清sCD40L水平较对照组显著降低（3.17±1.01μg/L比4.05±0.96μg/L,P〈0.01）。结论替罗非班可降低MACE发生率,在老年NSTEACS患者PCI中疗效确切,能显著降低sCD40L的水平。

Effect of tirofiban on levels of serum soluble CD40 ligand in elderly patients with non-ST elevation acute coronary syndrome treated by percutaneous coronary intervention

Objective To observe the levels of serum soluble CD40 ligand （sCD40L） in elderly patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention. Methods Eighty elderly patients with high-risk non-ST elevation acute coronary syndrome receiving triofiban and percutaneous coronary intervention were divided randomly into the control group （ n = 43 ） and tirofiban group （ n = 37）. Major adverse cardiac events （MACE） rates during in hospital stay and during a follow up of 30 days were analyzed and compared between the two groups. Enzyme-linked immynosorbent assay was used to measue levels of sCD40L in all patients before and after their treatment. Results The MACE rate at 30 days was significantly lower in the tirofiban group than in the control group （ 9. 5% vs 18. 9% ）. There were no significant differences in the incidence of bleeding events or platelet count between the two groups （P 〉 0. 05）. Level of sCD40L was significantly decreased in the tirofiban group after PCI compared with the control （3.17±1.01μg/L vs 4. 05 ± 0. 96 μg/L, P〈0. 01）. Conclusion Tirofiban can reduce the incidence of MACE and the level of sCD40L and can be used in elderly NSTE-ACS patients during PCI.