急性冠状动脉综合征患者血浆sCD40L和MMP-9的变化及相关性研究

目的: 观察不同类型冠心病患者血浆中可溶性CD40配体(sCD40L)、基质金属蛋白酶-9(MMP-9)的水平变化及其相关性,探讨sCD40L、MMP-9与急性冠状动脉综合征(acute coronary syndromes,ACS)发生的关系,评价血浆sCD40L及MMP-9水平作为粥样斑块破裂的血浆学指标意义。方法: 选取ACS患者48例,稳定型冠心病(SCHD)患者17例及正常对照组15名,采用酶联免疫吸附试验测定血浆sCD40L、MMP-9水平,分析其相关性。结果: ACS患者血浆sCD40L水平均显著高于SCHD组和对照组(P<0.01),ACS患者血浆MMP-9水平亦显著高于SCHD组和对照组(P<0.01),ACS患者血浆sCD40L与MMP-9呈显著的正相关关系(P<0.01)。结论: 急性冠状动脉综合征患者外周血浆sCD40L和MMP-9水平明显升高,可能与不稳定粥样斑块破裂密切相关,可作为动脉粥样硬化斑块不稳定的标志。

Relativity study on the changes of soluble plasma CD40L and matrix metalloproteinase-9 levels in patients with acute coronary syndrome

Objective: To observe changes of the level of soluble plasma CD40 ligand (sCD40L) and matrix metalloproteinase-9 (MMP-9) in patients with various coronary heart diseases and their correlations with the development of acute coronary syndrome (ACS), and to evaluate the significance of sCD40L and MMP-9 as plasma target of plague rupture. Methods: Forty-eight patients with ACS, 17 with stable coronary heart disease (SCHD) and 15 normal controls were concluded in the study. Their plasma levels of sCD40L and MMP-9 were measured with enzyme-linked immunosorbent assay. Results: The plasma level of sCD40L in patients with ACS was significantly higher than that of patients with SCHD and normal controls (P<0.01). MMP-9 level was significantly higher in patients with ACS than in those with SCHD and normal controls (P<0.01). There was a positive correlation between the levels of sCD40L and MMP-9 (P<0.01). Conclusions: The plasma levels of both sCD40L and MMP-9 are elevated significantly in patients with acute coronary syndrome, which suggests that they may have close correlation with the rupture of the unstable atheromatous plagues and may serve as a potential marker of plague stability.