急性冠脉综合征患者OX40配体表达的变化

目的： 探讨急性冠脉综合征（ACS）患者外周血单核细胞表达OX40配体（OX40L）及血清可溶性OX40L（sOX40L）水平变化的临床意义。方法: 应用流式细胞术和双抗夹心酶联免疫测定法（ELISA）分别对正常对照组30例、稳定心绞痛（SA）40例（包括20例PTCA）、不稳定心绞痛（UA）50例、急性心肌梗死（AMI）30例患者血单核细胞表达OX40L及血清可溶性sOX40L水平进行检测。结果: UA组［(67.1±12.3)MFI］及AMI组［(70.2±18.3)MFI］血单核细胞表达OX40L，血清sOX40L水平［(35.7±8.4)ng/L,(38.1±10.5)ng/L］明显高于SA组［(23.1±6.7)MFI, (13.6±4.1)ng/L］和对照组［(20.8±8.1)MFI,(12.8±3.6)ng/L］。AMI患者血清sOX40L水平与UA组无明显差异，但AMI发病后24 h sOX40L有一升高峰值。PTCA后血清sOX40L明显高于PTCA前， 但血单核细胞表达OX40L无差异。结论: OX40L表达可能参与ACS的发生机制，且可能是冠脉斑块不稳定的活动性标志物。

Changes of OX40 ligand expression in patients with acute coronary syndromes

AIM: To investigate the changes of OX40 ligand expression on monocytes and serum soluble OX40 ligand in patients with acute coronary syndromes (ACS).METHODS: The present study included healthy controls (n=30), patients with stable angina (SA, n=40) and patients with ACS, including unstable angina (UA, n=50) and acute myocardial infarction (AMI, n=30). The expression of OX40L on platelets was analyzed with flow cytometry and serum level of soluble OX40L (sOX40L) was determined with ELISA.RESULTS: The expression of OX40L on monocytes and serum level of sOX40L were significantly higher in patients with UA and AMI compared to healthy controls and patients with SA. In patients with AMI, sOX40L levels showed no significant increase when compared to patients with UA, while AMI patients had a peak level of sOX40L at 24 h after AMI. Percutaneous transluminal coronary angioplasty (PTCA) induced a marked rise in sOX40L levels in all patients. However, OX40L expression on monocytes showed no difference between patients with PTCA, before and after operation.CONCLUSION: The expression of OX40L may participate the mechanism of ACS and represent a marker for the activity of coronary disease.