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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。
Objective To observe the effect of tirofiban on elderly patients with non-ST-segment elevation acute coronary syndrome (PCI) and its effect on serum soluble CD40 ligand (sCD40L). Methods Eighty elderly NSTEACS patients with high risk of stratification were randomly divided into tirofiban group (n = 43) and control group (n = 37). The main cardiovascular events (MACE) during hospitalization and within 30 days after operation were observed. Serum levels of sCD40L in all patients were measured by enzyme-linked immunosorbent assay (ELISA). Results Compared with the control group, the incidence of MACE during hospitalization and after 30 days was lower in the tirofiban group (9.5% vs 18.9%, P> 0.05). There was no significant difference in the incidence of major bleeding between the two groups ; Tirofiban mild bleeding (10/43) compared with the control group (7/37) increased, but the difference was not statistically significant (P> 0.05); tirofiban treatment group serum sCD40L levels were significantly higher than the control group (3.17 ± 1.01μg / L vs 4.05 ± 0.96μg / L, P <0.01). Conclusion Tirofiban can reduce the incidence of MACE and has the exact effect in elderly NSTEACS patients with PCI, which can significantly reduce the level of sCD40L.