血清可溶性CD40L对急性冠状动脉综合症预后判断的临床意义

目的探讨检测血清sCD40L对急性冠状动脉综合征（ACS）预后的判断价值。方法检测并比较132例急性冠状动脉综合征患者（ACS组）与120名健康成人（健康对照组）的血清sCD40L水平,并随访记录1年内所有急性冠状动脉综合征患者再次心血管事件发生情况,以血清sCD40L水平为标准,将所有观察对象平均分为四组,比较分析各组急性冠状动脉患者心血管事件再次发生的差异,同时应用ROC曲线分析血清sCD40L水平对急性冠状动脉患者心血管事件再次发生的预测能力。结果 ACS组患者血清sCD40L水平显著高于健康对照组（P〈0.05）。随访结果表明随着各组血清sCD40L水平升高,心血管事件再次频率以及严重程度显著增加,血清sCD40L水平预测急性冠状动脉综合症再次发生心血管事件曲线下面积为0.718,其血清sCD40L水平最佳临界值为7.13 ng/L,预测的灵敏度和特异性分别为70.60%和65.10%。预测死亡病例发生的曲线下面积为0.703,其血清sCD40L水平最佳临界值为6.36 ng/L,预测的灵敏度和特异性分别为100%和32.0%。结论检测血清sCD40L水平对ACS患者预后的判断有一定临床价值。

Role of Serum Soluble CD40L in Evaluating Prognosis of Acute Coronary Syndrome

Objective To explore the prognostic value of serum soluble CD40L in acute coronary syndrome(ACS). Methods The serum levels of sCD40L of 132 patients with ACS and 120 healthy adults were determined and compared.All the ACS patients were divided into four groups according to the serum levels of sCD40L,and the recurrence rates of cardiovascular events within one year were followed-up and recorded.The prognostic ability of the serum level of sCD40L in acute coronary syndrome(ACS) was analyzed by ROC curves. Results The serum level of sCD40L in ACS patients was significantly higher than that of healthy control group(P<0.05).Follow-up results showed that the frequency of cardiovascular events was increased with increasing levels of serum sCD40L.A cut-off value of 7.13 ng/L for sCD40L predicted the recurrence of cardiovascular events the area under the curve was 0.718,with a sensitivity and specificity of 70.60% and 65.10%,respectively.A cut-off value of 6.36 ng/L for sCD40L predicted the recurrence of cardiovascular events the area under the curve was 0.703,with a sensitivity and specificity of 100% and 32.0%,respectively. Conclusions Detecting serum level of sCD40L has some clinical value in evaluating the prognosis of patients with ACS.