冠心病患者外周血炎症相关指标及ox-LDL和ox-LDL抗体的检测及其临床意义

目的：检测不同类型冠心病及非冠心病患者炎症相关指标可溶性CD40配体（sCD40L）、中性粒细胞胶原酶-8（MMP-8）、妊娠相关性血浆蛋白-A（PAPP—A），脂质过氧化和自身免疫指标氧化型低密度脂蛋白（ox—LDL）、氧化型低密度脂蛋白抗体（ox—LDLAb）水平，探讨其与急性冠脉综合征的相关性。方法：酶联免疫吸附法测定109例冠心病患者（包括急性心肌梗死组36例，不稳定心绞痛组38例，稳定心绞痛组35例）和非冠心病对照组36例外周血sCD40L，MMP-8，PAPP—A，ox—LDL和ox-LDLAb浓度。结果：急性冠脉综合征（包括急性心肌梗死和不稳定心绞痛）患者外周血中sCD40L，MMP-8，PAPP-A，ox-LDL和ox—LDLAb水平均高于稳定心绞痛患者（P〈0．05）和非冠心病对照患者；急性冠脉综合征中急性心肌梗死患者和不稳定心绞痛患者以上各指标水平的差异无统计学意义（P〉0．05）；与对照组相比，稳定心绞痛组各指标水平除PAPP—A外均高于对照组（P〈0．05）。各指标对于急性冠脉综合征都有一定的诊断价值（ROC曲线下面积0．7～0．9）。结论：外周血sCD40L，MMP-8，PAPP—A，ox-LDL和ox-LDLAb水平升高，参与了急性冠脉综合征的发生，可作为动脉粥样硬化斑块不稳定的血清学标志。

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Objective To detect the levels of index related to inflammation such as soluble CD40 ligand(sCD40L),neutrophil collagenase-8(MMP-8),and pregnancy associated plasma protein-A(PAPP-A),lipid peroxidation and autoimmune indexes such as oxidized low density lipoprotein(ox-LDL)and its antibody(ox-LDL Ab) in patients with coronary heart disease,and to investigate its relationship with acute coronary syndrome(ACS).Methods Contents of sCD40L,MMP-8,PAPP-A,ox-LDL and ox-LDL Ab in the peripheral blood were measured by enzyme-linked immunosorbent assay from 109 patients with coronary heart disease including 36 acute myocardial infarction(AMI),38 unstable angina pectoris(UAP),and 35 stable angina pectoris(SAP) and 36 controls without coronary heart disease.Results The levels of each index in the peripheral blood of ACS patients(including AMI and UAP) were higher than those of SAP patients and controls(P<0.05),and the difference of each index between UAP group and AMI group in ACS patients had no statistical significance(P>0.05).The levels of each index of SAP patients,except PAPP-A,were all higher than those of controls(P<0.05).All the indexes were helpful in diagnosis of ACS.The area under the ROC curve of each index is between 0.7 and 0.9.Conclusion The increase of sCD40L,MMP-8,PAPP-A,ox-LDL and ox-LDL Ab levels in peripheral blood may be related to the pathogenesis of ACS,and can be used as potential markers of unstable atherosclerosis plaque.