To Observe Levels Of SCD40L In The Acute Coronary Syndrome Patients And To Explore Levels Of SCD40L Atfer Percutaneous Coronary Intervention

Objective: To observe levels of sCD40L in the acute coronary syndrome(ACS) patients during the different periods, and explore the relationshipbetween plasma levels of sCD40L and coronary lesions, as well as theimpact and significance of tirofiban treatment to the levels of sCD40L.Methods:85hospitalized patients with coronary heart disease (55caseswere male and30were females, age39-81(61.9±9.5) years) in theJanuary2012January2013of the First Affiliated Hospital of JilinUniversity, Department of Cardiology were chosen. According to thenumber of coronary lesion branches (single, two, three) and the theGensini integral (low, medium, high), patients were divided into threesubgroups. According to the different clinical types (UA, AMI), andtreatment methods (stent or stent+tirofiban), patients were divided intotwo subgroups. Before the treatment, laboratory routine coagulation,blood routine examination, blood chemistry, liver function, blood lipidsand blood glucose, and the ECG, echocardiography and chest X-ray, andbody mass index (BMI) in all the patients were recorded, and the plasmalevels of sCD40L in different treatment periods were also measured.Results:(1) the levels of sCD40L in ACS group were significantly higherthan the control group, the levels of sCD40L in AMI subgroup weresignificantly higher than the UA subgroup(p <0.01).(2) sCD40L levelsincreased along with the increase of coronary lesion count and Gensiniscore, there was a significant difference among the subgroups(p <0.01).(3) There was no significant correlation between levels of sCD40L andLDL-C,HDL-C,BMI,WBC,Fbg,Age,hypertension,diabetes mellitus(p>0.05).(4) In the stent group,compared with preoperative levels of sCD40L, the postoperativeimmediate and48hours were significantly higher (p <0.01). In thestent+tirofiban group, the sCD40L levels of postoperative immediate weresignificantly higher than preoperative(p <0.01), but sCD40L levels ofpostoperative48hours was significantly lower than the stent group(p<0.01).(5) One case of gastrointestinal bleeding happened in stent groupduring hospitalization. Major adverse cardiac events and serious bleedingcomplications did not occur in stent+tirofiban group three months postdischarge.Conclusion:(1) plasma sCD40L levels are significantly higher in ACSgroup than normal control group.(2) sCD40L levels may reflect theseverity of coronary atherosclerosis.(3) PCI can result in elevated levelsof sCD40L, which may be caused by inflammatory response triggered byPCI. Tirofiban therapy can reduce levels of sCD40L, due to itsanti-inflammatory effects.(4)There was no significant correlation betweenlevels of sCD40L and LDL-C,HDL-C, BMI, WBC, Fbg,Age，hypertension，diabetes mellitus.