Effect Of Tirofiban On Serum Inflammatory Factors Level In Patients With Non-ST-elevation Acute Coronary Syndromes

Background:(1) Non-ST-elevation acute coronary syndromes(NSTE-ACS) is a kind of severely impair human health disease, including unstable angina and non-ST-segment elevation myocardial infarction. At present the anti-platelet holds the important position in the NSTE-ACS treatment. (2)Platelets are not only the important ingredient which the thrombus forms, simultaneously participates in the inflammation, releasing inflammation factor, like sCD40L.SCD40L infects the occurrence and development of atherosclerosis through inflammatory cells and inflammation factors. As a kind of chronic inflammatory cell the mast cells participate in the inflammation process of AS. Some researches indicated that the thrombus increased the level of hepatocyte growth factor (HGF) in serum through the accumulation of mast cells. HGF has the protective function in heart ischemical reperfusion injury. (3)Tirofiban is one kind of specificity non-peptide platelet glycoprotein again II b/Ⅲa acceptor antagonist, which can the competitive inhibit the platelet accumulation, induced by fibrinogen. It may contribute to the stability of atherosclerotic plaques and heart ischemical reperfusion injury.Object:To observe the change of serum concentrations of sCD40L, MCT, and HGF after the administration of tirofiban. To investigate the correlation between these factors and the contribution of tirofiban for the stability of atherosclerotic plaques and heart ischemical reperfusion injury.Method:45 NSTE-ACS patients were enrolled our study and randomly divided into two groups, the conventional treatment group (n=19) and the tirofiban group (n=26). Blood samples of all subjects were collected before the administration of medicines, after 6 hours and 24 hours. The serum concentrations of sCD40L, MCT and HGF were examined by ELISA.Result:(1)The level of serum sCD40L was lower after 24 hours than before in the group administrated with tirofiban(4.430±1.078ng/ml VS 5.217±0.882ng/ml, P= 0.004), and there were no significant differences at other time(P> 0.05).But there were no significant differences at any time in the conventional treatment group (P> 0.05). (2) The level of serum MCT was lower after 24 hours than before in the group administrated with tirofiban (7.699±0.822ng/ml VS 6.682±1.067ng/ml, P= 0.010), and there were e no significant differences at other time(P> 0.05).But there were no significant differences at any time in the conventional treatment group(P> 0.05).(3) There were no remarkable changes of the concentration of serum GHF at any time of both groups 山西医科大学硕士学位论文(P> 0.05). (4)The level of serum sCD40L and MCT at the time, when tirofiban was administrated after 24 hours, were significantly correlated each other(R= 0.816, P= 0.002).Conclusion:(1) The concentration of serum sCD40L and MCT was reduced after administrated with tirofiban. It may benefit for the stability of atherosclerotic plaques. (2)The level of serum sCD40L and MCT after administrated with tirofiban. were significantly correlated each other.This shows that sCD40L may affect the stability of atherosclerotic plaques through the activation of mast cell.