Study On The Changes Of SCD40L,MMPs-9 And CRP Before And After PCI In The Patients With Acute Coronary Syndrome

Objective:1,To observe the changes of the serum concentration of soluble CD40 ligand(sCD40L) matrix metallop roteinase 9 (MMPs-9)C reaction protein(CRP), before and after PCI ( percutaneous coronary interventio) in patients with different types of the coronary artery disease, explore the pathogenesis of coronary heart disease and the changes of sCD40L,MMPs-9 and CRP after PCI .2,To determine the relationship between sCD40L,MMPs-9 and CRP between the serum level of inflammatory factors and the coronary atherosclerotic plaque stability.Method:25 patients with acute coronary syndrome, 24 patients with stable angina pectoris were enrolled in our study. Meanwhile 20 healthy persons were selected as control. The serum level of soluble CD40 ligand(sCD40L),matrix metalloproteinase-9(MMP-9) and C reaction protein (CRP), were determined by enzyme-linked immunosorbent assay. The relationship between the serum inflammatory factors and unstable plaque were analized. Serial venous blood samples were obtained 1st day before and 1st day,5th day after PCI .Results:1,A group, B group patients sCD40L compared with the control group were significantly different (p <0.01) before and after PCI; preoperative A group B group patients sCD40L than control group (P<0.05). A postoperative intervention group, B group lesions sCD40L concentrations higher than the intervention group before treatment (p<0.05), the control group no significant change (P>0.05).2,Preoperative A group, B group patients MMPs-9 compared with the control group were significantly different, (p<0.01); pre-operative A group, B group patients MMPs-9 were higher (P<0.05). Intervention after A, B group of patients with serum concentrations of MMPs-9 is higher than preoperatively (p<0.05); after 1st day increased most significantly, after 5 days still remain at a relatively high level; the control group did not change.3,A group of patients with preoperative CRP compared with the control group were significantly different, (p<0.01); B group compared with the control group no significant change (P>0.05). Intervention after A, B group of patients with serum CRP concentration higher than the preoperative (p<0.05); after A group of five days remained at a relatively high level; B group and control group did not change.4,In postoperative sCD40L concentration and MMPs-9 concentration was positively correlated, r = 0.467, P<0.01.Conclusion:1,The increase of sCD40L and MMPs-9 in patients of CHD suggest that it may promote the triggering and propagation of CHD. The increases of sCD40L and MMPs-9 after PCI are correlated to the factors of crushing atherosclerosis like balloon inflation,in-stent and so on ,revascular after coronary injurying and reflow is another reason .2,The increases of sCD40L and MMPs-9 are correlated to the degree of atherosclerotic plaques. However, pre-operative plaque instability is the main reason may be more. These factors can identify unstable plaques as markers of peripheral blood, sCD40L may be more sensitive. Acute coronary syndrome patients with plaque instability, stent intervention to stimulate inflammatory response after treatment, serum levels of inflammatory factors, the preoperative and postoperative anti-inflammatory should be to strengthen the need for anti-platelet therapy.