| Objective: Acute coronary syndrome (ACS) is acute coronary heart disease. It is a serious threat to human health. With the application of Percutaneous coronary intervention in patients, it have greatly improved the success rate of resuscitation and survival in patients with ACS. but the overall prognosis of patients is poor, their mortality. Re-admission rates are very high. Hemagglutinating of ACS patients is increased in a prothrombotic state, such coagulation status are likely to be risk factors to affecr prognosis of patients. We're trying to detect molecular markers of GPⅡb /Ⅲa and P-selectin to explore the status of ACS abnormal blood clotting mechanism, and do further analysis of their different ages, sex and different prognosis of coronary heart disease risk stratification whether there are differences .Methods:In this study, highly selective 60 cases of ACS patients in our hospital from March 2008 - September 2,009 as experimental group. Underwent percutaneous coronary intervention (PCI) and after treatment with tirofiban in ACS Set A group only receiving PCI for the B group.Every group has 30 cases. The same period after coronary angiography (CAG) confirmed the negative crowd 30 cases of group C as the control group. ACS patients were confirmed by coronary angiography, coronary angiography showed stenosis≥75%. Grouping the same time, risk stratification based on the following factors: age, sex, smoking history, drinking history, blood glucose, blood lipids, blood pressure and so on. Test group was given low molecular weight heparin, aspirin, clopidogrel tablet. All patients were on preoperative 1h, after 30min, 2h, 12h check median cubital vein of platelet GPIIb / IIIa, P-selectin levels. All blood samples were taken at the submission, within 10min after blood sampling, platelet GPIIb / IIIa, P-selectin for inspection be completed within 2h after the test. Comparing different groups of GPⅡb /Ⅲa, and P-selectin differences and after the intervention of Tirofiban in short-term prognosis (hospital major adverse cardiac events (MACE) occurrence, and followed up for 3 months, adverse cardiac events) relationship. Statistical methods using SPSS 13.0 software package to P <0.05 (both sides) to have significant differences.Results: 1, . There was no significant difference in A, B, C three groups in age, gender, risk factors for coronary heart disease, etc. A group, B group, the composition of AMI and UA compared with no difference (P = 0.715).2, A group and B group characteristics of coronary angiography: A group's diseases tally included 51 vessels, of which 15 patients with single vessel diseas , double vessel disease in 9 cases, three vessel disease in 6 cases.There were 27 cases involving the left anterior descending artery, left circumflex 12 cases, right coronary artery 11 cases. There were 54 vascular lesions in Group B , single-vessel disease in 14 cases, double vessel disease in 8 cases, three lesions in 8 cases; 30 cases involving the left anterior descending artery, left circumflex branch in 12 cases, right coronary artery in 12 cases.There was no statistically significant difference in A, B two groups of coronary artery lesion and lesion count (P value is 0.939,0.769, respectively).3, Preoperative, A, B, C three groups of platelet membrane GPⅡb /Ⅲa, P-selectin levels measured results show that, A, B and C groups had significant difference, A group and B group hade no difference.4 After 30min A group and B group of the platelet membrane GPⅡb /Ⅲa, P-selectin was significantly higher than preoperative levels. C group compared with preoperative, there was no significant difference. Because group A used of tirofiban after operation, platelet membrane GPⅡb /Ⅲa, P-selectin levels slightly belowed the B group5 After 2 hours, GPⅡb /Ⅲa and P-selectin decreased significantly, Compared with the preoperative, A group and B group had significant difference.A group GPⅡb /Ⅲa and P-selectin levels of less than B group, C group had no significant difference.6 12h after operation , A group's GPⅡb /Ⅲa and P-selectin levels have been lower than the preoperative levels. B group, GPⅡb /Ⅲa and P-selectin levels of the more or less the same compared with 2h after operation, C group had no significant differences compared with preoperation .7 One month after PCI, A group had no death and the outbreak of angina pectoris; B had no death, angina occurred in 3 patients. After three months, A Group 1 cases of angina pectoris occured, no death; B group death occurred in 2 cases, 3 cases of recurrence of angina pectoris. Issued by the CAG patients confirmed angina author-stent restenosis.Conclusion: 1, Platelet GPⅡb /Ⅲa and P-selectin levels were significantly increased after PCI. Suggesting that PCI may be further activate the process of platelet activity This may be related to postoperative complications. 2.Tirofiban can quickly make GPⅡb /Ⅲa and P-selectin low. reduce coronary thrombosis and restenosis effectively. stent implantation to reduce inflammation, reduce mortality, improve quality of life in patients.
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