替罗非班对急性冠状动脉综合征患者经皮冠状动脉介入术后血浆可溶性OX40L的影响

目的:探讨替罗非班对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后血浆可溶性OX40L(sOX40L)水平的影响。方法:66例ACS患者设为ACS组,并根据治疗方法不同分为支架组和替罗非班组,支架组给予常规PCI介入治疗,替罗非班组给予PCI联合替罗非班治疗。另选择同期在我院疑似冠心病并经冠状动脉造影检查确认冠脉无狭窄者30例为对照组。测定术前1天、术后即刻及术后24h、48h、10d血浆sOX40L和超敏C反应蛋白(hs-CRP)水平。结果:术前ACS组血浆sOX40L和hs-CRP水平显著高于对照组(P<0.05);在ACS不同的临床类型中,心肌梗死(MI组)sOX40L和hs-CRP水平显著高于不稳定型心绞痛(UA组)(P<0.05);在不同的冠脉病变支数中,sOX40L和hs-CRP含量:三支病变组>双支病变组>单支病变组,各组间差异有统计学意义(P<0.05);术后即刻及术后24h、48h、10d替罗非班组sOX40L水平显著低于支架组(P<0.05);替罗非班治疗后无严重并发症发生。结论:ACS患者血浆sOX40L水平显著上升,且与冠状动脉粥样硬化病变的严重程度相关;替罗非班可降低ACS患者PCI后血浆sOX40L水平。

Effects of Tirofiban on the Plasma Soluble OX40L in Patients with ACS after PCI Treatment

OBJECTIVE: To investigate the effect of tirofiban on the plasma soluble OX40L (sOX40L) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) treatment. METHODS: 66 cases of ACS were included in ACS group and divided into stent group and tirofiban group according to different treatment. Stent group was given the PCI treatment, and the tirofiban group was given the PCI combined with tirofiban treatment. 30 patients suspected to coronary disease and digonsed as no coronary artery stenosis by contrast examination were included in control group. The plasma sOX40L and hs-CRP levels were measured 1 d before surgery, immediately after operation, 24 h, 48 h and 10 d after operation. RESULTS: The preoperative plasma sOX40L and hs-CRP levels of ACS group were significantly higher than control group (P<0.05). In different clinical types of ACS, the sOX40L and hs-CRP levels of MI group were significantly higher than the UA group (P<0.05). In different count of coronary artery disease, the order of sOX40L and hs-CRP levels was as follows: three artery lesion group>double artery lesion group>single artery lesion group, there was significant difference among three groups (P<0.05). Immediately after operation,24 h,48 h and 10 d after operation, the sOX40L level of tirofiban group was significantly lower than that of stent group (P<0.05). There was no serious complications in the tirofiban group. CONCLUSIONS: The plasma sOX40L level of ACS patients increases significantly, and it is closely related to the severity of coronary atherosclerosis. Tirofiban can reduce the level of plasma sOX40L in ACS patients after PCI treatment.