基质金属蛋白酶-9基因多态性与新疆维吾尔族急性冠脉综合征的相关性

目的 探讨新疆维吾尔族人群基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)基因多态性与急性冠脉综合征(acute coronary syndrome,ACS)的相关性.方法 采用病例对照研究,选择2006年1月至2009年12月在新疆医科大学第一附属医院心脏中心住院并行冠状动脉造影检查证实的维吾尔族急性冠脉综合征患者352例(包括不稳定型心绞痛213例、急性心肌梗死139例)和同期入院冠状动脉造影检查阴性的对照组421例.采用聚合酶链反应-限制性片段长度多态性技术对所有纳入对象的MMP-9基因-1562C＞T和R279Q多态性进行分析,并结合造影情况,探讨MMP-9基因多态性与ACS发生及冠脉狭窄程度的关系.用Hardv-Weinberg平衡检验样本群体代表性;各组基因型和等位基因频率差异比较采用x2检验,并以优势比(OR)及其95%可信区间(95%CI)表示相对的风险度;综合评价各因素与ACS相关性采用多因素Logistic回归分析;以P＜0.05为差异具有统计学意义.结果 MMP-9基因-1562C＞T多态性位点ACS组CT+TT基因型和T等位基因频率(25.9%,14.5%)显著高于对照组(15.7%,8.4%),差异有统计学意义(P＜0.01).R279Q位点ACS组和对照组RQ+QQ基因型和Q等位基因频率分别为67.0%,45.6%,64.6%,42.0%,两组比较差异无统计学意义(P＞0.05).多因素Logistic回归分析显示-1562T等位基因是ACS发生的独立风险因素(P＜0.05).不同冠脉病变支数亚组中CT+TT基因型和CC基因型的分布比较差异无统计学意义(P＞0.05).结论 MMP-9基因1562C＞T多态性与新疆维吾尔族人群ACS的发生可能相关,T等位基因可能是ACS遗传易感性的基因标记之一,-1562C＞T基因多态性与ACS冠脉狭窄程度无关,R279Q基因多态性与维吾尔族人群ACS发生未见明显相关.     

ACE基因及CD14/-159基因多态性与变应性鼻炎关系的研究

目的通过对血管紧张素转换酶(angiotensin converting enzyme,ACE)基因插入/缺失的多态性及CD14/-159基因多态性分析,探讨其在变应性鼻炎(allergic rhinitis,AR)发病中的作用。方法采用PCR扩增及多聚酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)分析方法测定60例AR患者、40例健康体检者的ACE和CD14/-159基因型的分布情况,并对结果进行统计分析。结果ACE等位基因I、D频率在AR组和健康对照组间的分布具有显著性差异(X~2=17.37,P<0.005),等位基因D与AR的易感性相关(OR=3.46,95%CI=1.92～6.23,P<0.005)。CD14/-159等位基因C、T频率在AR组和健康对照组间的分布具有显著性差异(X~2= 14.53,P<0.005),等位基因C与AR的易感性相关(OR=3.1,95%CI=1.75～5.47,P<0.005)。两组ACE基因型(II、ID、DD)频率的分布比较有显著性差异(X~2=15.41,P<0.005);两组CD14/-159基因型(CC、CT、TT)频率的分布比较具有显著性差异(X~2=11.77,P<0.005)。结论ACE基因多态性与CD14/-159基因的多态性是影响AR的重要候选基因,其中以DD、ID、CC基因型和D、C等位基因与AR的易感性相关。     

冠心病患者CD40、CD40L、sCD40L的水平及其意义

目的:探讨单核细胞上CD40和其配体CD40L及血浆中游离型的配体sCD40L在冠心病(coronary heart disease,CHD)患者中的水平及其临床意义。方法:将36例CHD病例分为两组,稳定型心绞痛(stable angina,SA)组和急性冠脉综合征(acute coronary syndrome,ACS)组,分别检测外周血单核细胞上CD40、CD40L表达水平及血浆中sCD40L浓度,并与19例对照组相比较。结果:ACS组患者外周血单核细胞上CD40的表达水平明显高于SA组、对照组;ACS组、SA组患者血浆sCD40L浓度明显高于对照组(P<0.05);外周血单核细胞CD40与CD40L表达水平呈正相关(r=0.41,P=0.002);外周血单核细胞CD40表达水平与血浆sCD40L浓度呈正相关(r=0.367,P=0.006)。结论:CD40-CD40L通路可能与ACS的形成有关,阻断CD40-CD40L信号途径可能成为防治动脉粥样硬化的一个重要靶点。     

福建地区汉族人群骨保护素基因位点多态性与急性冠脉综合征的相关性研究

目的 探讨福建地区汉族人群骨保护素(OPG)基因209G/A、245T/G、1181G/C位点基因多态性与急性冠脉综合征(ACS)及其病变程度的相关性.方法 采用前瞻性研究方法,选取2010年7月至2011年9月252例福建地区无血缘关系的汉族人为研究对象,纳入的184例ACS患者再根据冠状动脉(冠脉)造影结果分为单支病变组(60例)、双支病变组(68例)、多支病变组(54例),其中2例造影冠脉无狭窄;以68例建康体检者为对照.取静脉血提取DNA,采用Sanger测序法检测各组OPG基因209G/A、245T/G、1181G/C位点多态性.分析ACS组与对照组之间以及ACS不同病变程度组之间209G/A、245T/G、1181G/C各基因型和等位基因的分布频率以及基因多态性与ACS病变程度的关系.结果 ACS组与对照组OPG 209G/A、245T/G位点基因型及等位基因分布均无明显差异;而1181G/C位点基因型分布[GG型:92(50.0％)比43(63.2％),CC型:26(14.1％)比0,GC型:66(35.9％)比25 (36.8％),x2=11.240,P=0.004]、等位基因分布[等位基因G:250(67.9％)比111(81.6％),等位基因C:118(32.1％)比25(18.4％),x2=9.148,P=0.002]差异均有统计学意义.进一步分析发现,ACS单支病变组、双支病变组及多支病变组209G/A、245T/G及1181G/C位点分布比较均无明显差异.结论 福建地区汉族人群OPG 209G/A、245T/G位点多态性与ACS无明显相关性;1181G/C位点基因多态性与ACS发病之间存在相关性,但与其病变程度无关.     

C反应蛋白1059G/C基因多态性与急性冠脉综合征的相关性研究

目的探讨昆明地区汉族人群中血清C反应蛋白1059G/C基因多态性与急性冠脉综合征之间的相关性。方法采用DNA测序,对100例急性冠脉综合征(acute coronary syndromes,ACS)患者和100例健康体检者的基因型进行鉴定,结合冠状动脉造影结果进行分析。结果 C反应蛋白1059G/C基因多态性等位基因和基因型的分布频率符合Hardy-Weinberg平衡(x~2=0.297,P0.05)。两组的1059G/C基因型和等位基因的分布趋势相同,差异无显著性(P0.05)。冠状动脉病变程度不受1059G/C基因多态性的影响(x~2=1.374,P0.05)。结论急性冠脉综合征患者冠状动脉病变程度可能不受1059G/C基因多态性的影响。     

华东地区汉族人群早发急性冠脉综合征患者血小板反应素-4基因G29926C多态性分析

目的:探讨中国华东地区汉族人群血小板反应素-4(thrombospondin-4,TSP-4)基因G29926C(A387P)多态性与早发急性冠脉综合征(ACS)发病的关联性。方法:应用聚合酶链反应-限制性片段长度多态性方法,检测102例早发ACS患者(病例组)和121例年龄及性别相匹配的非冠心病者(对照组)的TSP-4A387P多态性。结果:GC基因型在病例组和对照组的分布差异无统计学意义(5.9%vs7.4%,P=0.64),未检测到CC纯合子。C等位基因频率在病例组和对照组分别为2.9%、3.7%(P=0.65)。Logistic回归分析显示,TSP-4A387P多态性与早发ACS的发生无显著性相关(OR=0.71,95%CI:0.22～2.28,P=0.57)。结论:TSP-4基因387A→P变异在中国华东地区汉族人群中发生频率明显低于西方人群,且与早发ACS的发病无显著相关性。     

GAS6基因344-35C/T多态性与脑梗死的相关性研究

目的探讨粤西地区汉族人群中生长停滞特异性基因6(GAS6基因)内含子SNP344-35C/T位点的单核苷酸多态性(SNP)与脑梗死的相关性。方法应用聚合酶链反应-限制性内切酶片段长度多态性分析方法(PCR-RFLP)检测180例脑梗死患者和150例健康对照的GAS6基因内含子SNP344-35C/T的基因型。结果 GAS6基因内含子SNP344-35C/T基因型及等位基因频率在病例组与对照组之间无显著性差异(P>0.05),经性别分层分析发现,女性C等位基因频率(77.9%)高于对照组(66.4%)(P=0.040);CC基因型频率(61.8%)高于对照组(43.1%)(P=0.036)。结论 GAS6基因内含子SNP344-35C/T位点与粤西地区汉族女性脑梗死有关,C等位基因是女性脑梗死的危险因素,CC基因型为女性脑梗死的易感基因型。     

CD40-1C/T基因多态性与系统性红斑狼疮的相关性研究

目的研究CD40基因5’非翻译区(5’UTR)-1位点C/T单核苷酸多态性(SNP)在该地区系统性红斑狼疮(SLE)人群中的分布,探讨其与SLE的易感相关性。方法采用病例-对照研究方法,以107例门诊和住院SLE患者为研究对象,与109例正常对照组进行研究。应用聚合酶链反应-限制性内切酶片段长度多态性(PCR-RFLP)测定CD40基因-1位点C/T单核苷酸多态性,计算基因型及等位基因频率;同时将CD40基因-1C/T位点的三种基因型与SLE患者各种自身抗体检测结果进行比较。结果CD40基因-1C/T位点的基因型频率在SLE组和对照组中的分布差异有统计学显著性意义(P=0.035),其中SLE组的CC基因型频率明显高于对照组(OR值=2.020,P=0.016),CT基因型频率明显低于对照组(OR值=0.528,P=0.020);而等位基因频率分布差异无统计学意义(P=0.114)。SLE患者的抗RNP,抗SSA,抗SSB,抗dsDNA和抗组蛋白抗体在CC基因型中的阳性率最高。结论CD40基因5’非翻译区-1位点CC基因型可能与该地区SLE的发生有关。     

载脂蛋白A5、C3基因多态性与急性冠脉综合征及合并高血压关系

目的分析APOA5-1131TC、APOC3 3238CG基因多态性与急性冠脉综合征(ACS)及ACS合并高血压的关系。方法用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术分析223例ACS患者及201例健康对照者基因型,并选取部分DNA进行测序验证,用全自动生化分析仪测定血脂水平,并用Shesis软件进行Hardy-Weinberg平衡吻合性检验和单倍型分析。结果 APOA5-1131TC及APOC3 3238CG在ACS组和健康对照组中均具有群体代表性(P0.05),两位点SNP无明显连锁不平衡(D'=0.172,r2=0.024);与健康对照组比较,ACS组APOA5-1131TC TC、CC基因型和C等位基因频率显著升高(P0.05),而APOC3 3238CG差异无统计学意义(P0.05)。血清TG水平在APOA5-1131TC及APOC3 3238CG的3种基因型间差异均有统计学意义(P均0.05)。APOA5-1131TC分析显示,ACS合并高血压与健康对照组比较,TC、CC、TC+CC与TT基因型比较差异有统计学意义(P0.05),T及C等位基因间差异亦有统计学意义(P0.01);危险因素分析结果显示,-1131C等位基因与ACS密切相关[OR(95%CI)=1.62(1.12~2.17)]。单倍型分析结果显示,H2和H4型在ACS组和健康对照组中差异有统计学意义(P0.01)。结论 APOA5-1131C等位基因与ACS及ACS合并高血压密切相关、APOC3 3238CG未发现与ACS相关,两位点SNP均与ACS患者TG水平升高有关。     

宁夏地区Graves'病与CTLA-4基因多态性相关性研究

目的 探讨细胞毒性T淋巴细胞相关抗原4(CLTA-4)基因多态性与宁夏人群Graves'病(GD)的相关性.方法 应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术分析61例GD患者和60名对照者的CTLA-4基因第一外显子(49)A/G位点和启动子(318)C/T位点多态性.结果 GD患者组与对照组之间CTLA-4基因SNP (49)A/G的基因型分布(χ 2=9.277,P＜0.05)及等位基因频率(χ 2= 10.831,P＜0.05)差异有统计学意义;SNP(318)C/T的基因型分布(χ 2= 0.446,P>0.05)及等位基因频率(χ 2= 0.489,P>0.05)差异无统计学意义.结论 CTLA-4基因第一外显子的(49)A/G位点的多态性与宁夏地区GD的发生可能相关.     

The clinical implications of increased OX40 ligand expression in patients with acute coronary syndrome

BACKGROUND: Increasing evidence show that OX40 ligand (OX40L), also known as tumor necrosis factor superfamily member 4 (TNFSF4), plays an important role in the pathogenesis of atherosclerosis. We investigated whether expression levels of soluble OX40L in serum and of membrane OX40L on platelets were related to serum concentrations of matrix metalloproteinases (MMPs) and stability of coronary atherosclerotic plaque in patients with acute coronary syndrome (ACS). METHODS: We included healthy controls (n=30), patients with stable angina (SA) (n=40) and patients with ACS, including unstable angina (UA) (n=70) and acute myocardial infarction (AMI) (n=40). The expression of OX40L on platelets (pOX40L) was analyzed with flow cytometry whereas serum concentrations of soluble OX40L (sOX40L), MMP-9 and MMP-3 were determined with ELISA. All coronary stenoses with >/=30% diameter reduction were assessed by angiographic coronary stenosis morphology. RESULTS: The expression of OX40L on platelets were significantly higher in patients with ACS (61.5+/-11.5) compared with healthy controls (28.9+/-7.4) or with the group of patients with SA (31.2+/-8.1) (mean fluorescence intensity+/-SD) (p<0.001). Similarly, we observed higher sOX40L concentrations in patients with ACS (34.6+/-9.3) compared with controls (10.2+/-4.7) or patients with SA (11.4+/-5.8) (ng/ml+/-SD) (p<0.001). Serum MMP-3 and MMP-9 levels in patients were two times greater than those in the control group. A positive correlation was observed between OX40L expression on platelets and MMP-9 and MMP-3 serum concentrations. OX40L expression on platelets were furthermore correlated with soluble OX40L in serum and with complex coronary stenoses (r1=0.61, r2=0.57, p<0.001). CONCLUSION: Patients with ACS show increased OX40L system (pOX40L and sOX40L) expression which may create a proinflammatory milieu for aggravating the development of atherosclerosis, and may be a valuable marker for predicting the severity of ACS.     

Association of MMP-9 gene polymorphisms with acute coronary syndrome in the Uygur population of China

BACKGROUND: Matrix metalloproteinase-9 (MMP-9) plays a pivotal role in early atherosclerosis, vascular remodeling and development of atherosclerotic lesion. The potentially functional MMP-9 gene polymorphism may contribute to the susceptibility of acute coronary syndrome (ACS). This study aimed to investigate the association between two single nucleotide polymorphisms (-1562C>T, R279Q) of the MMP-9 gene in patients with ACS in the Uygur population of China.METHODS: This case-control study was composed of 361 ACS patients and 432 control subjects, who had undergone coronary angiography. Among the ACS patients, 162 (44.9%) had single-vessel disease, 145 (40.2%) had two-vessel disease, and 54 (14.9%) had three-vessel disease. The genotypes of the two selected SNPs were determined by the method of polymerase chain reaction and restriction fragment length polymorphism (RFLP-PCR). The relationship between the polymorphism of the MMP-9 gene and the severity of coronary arterial stenosis was analyzed.RESULTS: Analysis of the two SNPs showed that the frequency of CT and TT genotypes in patients with ACS was significantly higher than that in the control group (ACS vs. controls; CT+TT: 25.5% vs. 15.8%, P=0.001). And the -1562 gene allele (C/T) was significantly associated with acute coronary syndrome (ACS vs. controls; C allele: 85.7% vs. 91.5%, T allele: 14.3% vs. 8.5%, P<0.001). But the frequencies of CT+TT and CC genotypes were not statistically different among ACS patients with one, two and three or more significantly diseased vessels (P=0.55). The R279Q polymorphism site with regard to the association with ACS was not significant (P>0.05). The presence of CT or TT genotypes, assuming codominant effect of the T allele, was independently associated with increased risk of coronary artery disease when adjustment was made for age, body mass index, smoking, hypertension and diabetes mellitus [odds ratio=1.737 (95% confidence interval, 1.337-2.257), P=0.018].CONCLUSIONS: MMP-9-1562C>T polymorphism is associated with the susceptibility to ACS in the Uygur population of China. However, this mutation apparently is not related to the severity of coronary arterial stenosis. Another SNP (R279Q) polymorphism of MMP-9 is not significantly associated with the risk of ACS.     

A common polymorphism in CD40 Kozak sequence (-1C/T) is associated with acute coronary syndrome

Objective

Evidence suggests the CD40-CD40L pathway as a key process in the development, progression, and outcome of acute coronary syndrome (ACS). We hypothesized that the -1C/T polymorphism of the CD40 gene would be associated with ACS and influence the CD40 expression.

Methods

The genotype distribution and allele frequency of CD40-1C/T polymorphism in 248 ACS patients and 206 controls were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Monocytes from 90 healthy volunteers were incubated with IFN-γ. CD40 expression was detected by flow cytometry.

Result

Patients with ACS showed a significant increase of CD40 expression compared with controls (P < 0.001). The frequency of the CC genotype in the ACS group was significantly higher than that of the controls (P < 0.001). Frequency of the C allele was higher among ACS patients compared with controls (P < 0.001). Case control association analysis of the CD40 -1C/T SNP showed an association between the C allele and ACS (OR = 1.991, 95%CI: 1.526 ∼ 2.596, P < 0.001). -1C/C carriers presented significantly higher CD40 expression levels than -1C/T and -1T/T subjects, both in ACS group and controls (P < 0.001). When stimulated by IFN-γ, CD40 expression levels on monocytes in individuals with CC, CT and TT genotypes were increased by 9.16, 3.83 and 1.53 fold, respectively, compared with the levels absent with IFN-γ.

Conclusions

These results suggest that the -1C allele of the CD40 (-1C/T) gene polymorphism is a genetic factor that may determine an individual's susceptibility by ACS in Chinese. The CD40 -1C/T polymorphism is a novel regulator of CD40 expression.     

冠心病患者外周血中CD19^＋细胞表达水平的意义

目的观察冠心病患者外周血中CD19^＋的表达水平,并探讨CD19^＋与炎症反应和脂质过氧化反应的关系。方法按美国心脏病学会/美国心脏学会冠心病处理指南的诊断标准并经冠状动脉造影检查确诊的冠心病患者60例,分为稳定型心绞痛（SA）组20例,急性冠状动脉综合征（ACS）组40例;并选择冠状动脉造影正常的20例非冠心病患者作为对照组。应用流式细胞术检测所有研究对象外周血中淋巴细胞表面CD19^＋的表达水平,比较各组CD19^＋的表达情况。同时检测C反应蛋白（CRP）和低密度脂蛋白胆固醇（LDL-C）浓度。并对CD19^＋细胞的表达率与CRP滴度和LDL-C进行Pearson直线相关分析。结果 ACS组患者B淋巴细胞CD19^＋表达率明显高于对照组（10.16±3.63）%vs（4.25±0.96）%（P〈0.01）,亦明显高于SA组（10.16±3.63）%vs（5.39±1.36）%（P〈0.01）;SA组CD19^＋细胞表达率和对照组患者CD19^＋细胞表达率相近（5.39±1.36）%vs（4.25±0.96）%（P〉0.05）。所研究对象外周血中CD19^＋细胞的表达水平与CRP滴度（r=0.661,P〈0.01）和LDL-C（r=0.351,P〈0.01）呈正相关。结论随着冠心病病情加重,冠心病患者外周血中B淋巴细胞CD19^＋的表达水平升高,CD19^＋的表达水平可反映冠心病危险分层,CD19^＋与炎症反应和脂质过氧化反应有关系。     

CD14C（-260）T启动子多态性对冠心病患者C反应蛋白水平的影响

目的探讨位于CD14基因启动子区域的C260T多态等位基因变异体CD14启动子区域-260位点C、T等位基因[CD14C(-260)T]启动子多态性对冠心病患者C反应蛋白水平的影响。方法通过研究82例稳定性冠心病患者的高敏C反应蛋白(hs-CRP)水平检测组织炎症。结果CD14基因中C260T多态性基因型分布如下:CC18例(22%)、TC48例(58.5%)、TT16例(19.5%)。相比于其它等位基因携带者TT型个体具有较高的hs-CRP(P=0.04)。具有较高百分比的T等位基因纯合子其hs-CRP>0.3mg/dl(P=0.01)。结论功能多态性的T纯合子在缺血性危险中是增高的,与hs-CRP>0.3mg/dl是独立相关的(P=0.004)。     

OX40 ligand levels and high-sensitivity C-reactive protein levels in blood from local coronary plaque and the femoral artery in patients with acute coronary syndrome or stable angina

OX40 ligand (OX40L) and high-sensitivity C-reactive protein (hs-CRP) play important roles in the pathogenesis of atherosclerosis. In this study, consecutive patients with acute coronary syndrome (ACS; n = 90) or stable angina (SA; n = 40) and healthy control subjects (n = 50) were evaluated to assess plasma OX40L and serum hs-CRP levels in local coronary plaque and the femoral artery. OX40L and hs-CRP levels in the femoral artery were significantly higher in patients with ACS compared with controls. OX40L and hsCRP levels in local coronary plaque (OX40L(c) and hs-CRP(c), respectively) were significantly higher in ACS than in SA patients. OX40L and hs-CRP levels were positively correlated with each other and were also correlated with fibrinogen levels. The number of complex lesions was correlated with OX40L(c) and hs-CRP(c) levels. It is concluded that the OX40L(c) level was highly sensitive for evaluating the inflammatory response in ACS and elevated levels of OX40L(c) may be a valuable predictive marker for increased risk of atherosclerotic progression in ACS patients.     

急性冠状动脉综合征患者C-反应蛋白及其1059G/C基因多态性的研究

目的：探讨中国汉族人群中C－反应蛋白（C-reactive protein,CRP)及其1059G／C基因多态性与急性冠状动脉综合征（acute coronary syndrome,ACS)的关系。方法：测定113例ACS患者（包括不稳定性心绞痛、急性心肌梗死）和109例对照组（非ACS，包括稳定性心绞痛、陈旧性心肌梗死）的CRP、纤维蛋白原（fibrinogen,Fbg)水平，并应用聚合酶链反应－限制性片段长度多态性（PCR－RELP）技术检测CRP的1059G／C基因多态性，结合冠状动脉造影结果进行分析。结果：ACS组的CRP水平显著高于对照组（P＜0．05），且冠状动脉3支病变和2支病变患者血清CRP水平亦均高于1支病变（P＜0．05）；但是Fbg水平与ACS和冠状动脉病变支数无关（P＞0．05）。CRP1059G／C基因型和等位基因的频率分布符合Hardy-Weinberg平衡（P＞0．05）。ACS组和对照组CRP 1059G／C基因型和等位基因的分布趋势相同，差异无显著性意义（P＞0．05）。（GC＋CC）基因型的血清CRP水平显著低于GC基因型（P＜0．05）。结论：血浆CRP水平升高可能是ACS发生的一种预测指标；CRP水平可能受其1059G／C基因多态性的影响。     

急性冠脉综合征患者高表达的CD40L和炎症因子相关性

目的 检测急性冠脉综合征(ACS)患者CD4+T细胞CINOL的表达率、其血清可溶性CD40配体(sCD40L)和高敏C反应蛋白(hsCRP)、细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)的浓度,分析CD40L(sCD40L)与炎症因子的相关性,探讨CD40/CD40L在ACS发病中的作用及可能途径.方法 采用前瞻性研究方法,选取2006.10-2007.4中山大学附属第一医院急诊科、心血管医学部冠心病患者32例,包括稳定性心绞痛(SAP)7例、不稳定性心绞痛(UAP)14例、急性心肌梗死(AMI)11例.正常对照组(CON)为与患者年龄、性别相匹配的健康志愿者8例.所有受试者均排除感染、肿瘤、风湿、肝肾功能不全,未使用类固醇和免疫抑制剂等.流式细胞分析术(FCM)检测CD4+T细胞表达CD40L的阳性细胞率,ELISA法检测血清sCD40L、ICAM-1和VCAM-1浓度,免疫比浊法检测血清hsCRP浓度.所有资料使用SPSS 11.0进行统计学分析.结果 ANI、UAP、SAP、CON组CD4+T细胞中表达CD40L的阳性细胞率(%)分别为8.60±3.02、3.24±1.13、2.18±1.80、0.59±0.18,AMI组显著高于其他3组(P＜0.05),UAP组亦显著高于CON组(P＜0.05);4组血清sCD40L浓度分别为14.47±8.00、8.06±6.96、7.32±3.58、4.48±1.49(ng/mL),ANI组明显高于其他3组(P＜0.05);4组血清:hsCRP浓度分别为20.30±7.57、14.04±8.03、3.78±4.99、O.93±0.77(mg/L),AMI组显著高于其他3组(P＜0.05),UAP组亦显著高于SAP组与CON组(P＜0.05);4组血清ICAM-1浓度分别为418.09±222.19、212.86±128.43、165.04±32.12、108.62±62.27(ng/mL),AMI组显著高于其他3组(均P＜O.05),UAP组亦高于CON组(P＜0.05);4组血清VCAM-1浓度分别为5540.02±2614.65、3760.95±1915.01、4167.27±2084.48、2405.65±870.45(ng/mL),AMI组显著高于CON组(P＜0.01);AMI组CD4+T细胞中表达CD40L的阳性细胞率与VCAM-1呈明显正相关性(r=0.730,P=0.011),其血清sCD40L与hsCRP、ICAM-1、VCAN-1呈明显正相关性(r=0.677,P=0.011;r:0.901,P=0.000;r=0.714,P=0.014).结论 急性冠脉综合征患者CD4+T细胞CINOL的表达率和血清sCINOL浓度升高,且与血清hsCRP、ICAN-1、VCAM-1呈明显正相关;在ACS发生中起作用,此和hsCRP、ICAM-1、VCAN-1等有关,而CD40L/sCD40L可望作为冠心病危险性的预测因子.