CD40L在慢性阻塞性肺疾病中的检测及临床意义

目的探讨可溶性CD40配体（sCD40L）、P-选择素（CD62P）在慢性阻塞性肺疾病（COPD）发病中的作用。方法病例来自2008年12月至2009年4月在我院呼吸一科住院患者,采用酶联免疫吸附测定法（ELISA）检测30例健康成人（对照组）、60例COPD急性加重期（AECOPD）患者治疗前后外周血浆sCD40L、CD62P水平;ADVIA120血细胞分析仪检测各组血小板（PLT）数量。结果 AECOPD治疗前组sCD40L[（2.71±0.94）μg/L]高于治疗后组[（1.74±0.56）μg/L]和对照组[（1.07±0.38）μg/L]（t=5.32、5.89,P均〈0.05）,治疗后组与对照组差异无统计学意义（t=1.23,P〉0.05）;治疗前组CD62P[（17.5±8.12）ng/mL]明显高于治疗后组[（10.9±6.58）ng/mL]和对照组[（2.53±1.03）ng/mL]（t=6.71、12.48,P均〈0.01）,治疗后组也明显高于对照组,差异有统计学意义（t=8.30,P〈0.01）;治疗前组、治疗后组及对照组血小板数差异无统计学意义（t=-1.32、-1.11、0.79,P均〉0.05）。结论 sCD40L、CD62P作为血小板活化标志物在AECOPD显著增高,表明AECOPD存在血小板活化,提示血小板作为一种炎性细胞以其活化形式参与AECOPD发病s;CD40L、CD62P可作为判断AECOPD严重程度及血小板活化程度的指标。

Detection and clinical significance of CD40L in chronic obstructive pulmonary disease

Objective To explore the role of sCD40L and CD62P in patients with chronic obstructive pulmonary disease（COPD）.Methods The blood plasma levels of sCD40L and CD62P in 30 healthy volunteers（control group） and 60 patients with acute exacerbation of COPD（AECOPD） before and after treatment were measured by ELISA.Platelet quantities of three groups were measured by ADVIA120 analysator.Results The level of sCD40L in patients before treatment [（2.71±0.94）μg /L] was significantly higher than that after treatmet [（1.74±0.56）μg /L] and that of the control group[（1.07±0.38）μg /L]（t=5.32、5.89,both P0.05）,but the difference of sCD40L between the post-treatment group and the control group was not significant（t=1.23,P0.05）.The level of CD62P in patients before treatment[（17.5±8.12）ng/mL]was significantly higher than those of after treatmet group [（10.9±6.58）ng/mL] and control group[（2.53±1.03）ng/mL]（t=6.71、12.48,both P0.01）,and the level of post-treatment group was also obviously higher than that of the control group（t=8.30,P0.01）.The difference of platelet quantities among three groups was not significant（t=-1.32、-1.11、0.79,all P0.05）.Conclusions The levels of sCD40L and CD62P as marker of platelet activation increase significantly during acute exacerbation of COPD,which suggests that platelet activation exists in acute exacerbation of COPD and platelet as a kind of inflammatory cell participates morbidity in acute exacerbation of COPD.It may be play an important function by activation form.The measurement of sCD40L and CD62P is useful to monitor platelet activation degree during acute exacerbation of COPD and may evaluate the severity of acute exacerbation of COPD.