冠心病患者血清sCD40L和MMP-9的变化及相关性

目的：观察不同类型冠心病患者中可溶性CD40配体（sCD40L）水平的变化及其与金属蛋白酶-9(MMP-9)之间的关系, 进一步探讨急性冠脉综合征临床识别和预测的炎症指标。方法：采用酶联免疫吸附法测定79例冠心病患者血清sCD40L,MMP-9的浓度。结果：急性冠脉综合征患者sCD40L水平［在不稳定心绞痛(UAP)和急性心肌梗死组(AMI)分别为(1.96± 0.84) ng/ml，(2.23 ±0.99 )ng/ml］显著高于稳定性冠心病组(1.20±0.76)ng/ml (P<0.05)，而在UAP和AMI组间比较差异无显著性（P>0.05），sCD40L水平与MMP-9呈显著正相关(r=0.401, P<0.01)。sCD40L水平与甘油三酯呈正相关(r=0.254, P=0.039)，与高密度脂蛋白胆固醇呈负相关(r=-0.234, P=0.031)。结论：急性冠脉综合征患者外周血清sCD40L和MMP-9水平升高，可能与急性冠脉综合征的发生有关，可能是动脉粥样硬化不稳定的标志，CD40L可能通过促使MMP-9的表达而促发急性冠脉综合征。

Changes and relations of soluble plasma CD40L and matrix metalloproteinase-9 levels in patients with coronary heart disease

OBJECTIVE: To investigate the serum soluble CD40 ligand (sCD40L) levels in coronary heart disease and its relationship with MMP-9 and to explore the potential predicting factor for the acute coronary syndrome. METHODS: Enzyme-linked immunosorbent assay was used to measure the sCD40L and MMP-9 in 79 patients with coronary heart disease. RESULTS: sCD40L level was significantly higher in patients with acute coronary syndrome (1.96 +/- 0.84) ng/ml and (2.23 +/- 0.99) ng/ml in unstable angina and acute myocardial infarction group, respectively] than in stable coronary heart disease patients (1.20 +/- 0.76) ng/ml, P < 0.05]. Serum sCD40L was significantly correlated with MMP-9 (r = 0.401 , P < 0.01), and sCD40L level was significantly correlated with TG (r = 0.254, P = 0.039), HDL (r = -0.234, P = 0.031), and HDL-C (r = -0.253, P = 0.024). CONCLUSION: Serum sCD40L and MMP-9 levels were elevated in acute coronary syndrome, suggesting the possible relation to the pathogenesis of ACS and it may serve as a potential marker of plaque stability.