急性冠脉综合征患者血清可溶性CD40L水平的临床研究

目的:探讨可溶性白细胞分化可溶性抗原40配体(sCD40L)和超敏C反应蛋白(hs-CRP)在急性冠脉综合征(ACS)患者发病及预后中的临床意义及机制。方法:根据急性冠脉综合征诊断标准选择86例患者,分为两组:正常对照组(NCHD)17例,ACS组69例,其中不稳定心绞痛(UA)58例,急性心肌梗死(AMI)11例,入院当天采用ELISA测定血清sCD40L浓度和hs-CRP水平。随诊2个月,观察急性心血管事件发生率。结果:ACS组明显高于对照组(P<0.01);AMI组略高于UA组但无统计学意义(P>0.05);sCD40L和或hs-CRP升高组心血管事件较正常组增多。结论:急性冠脉综合征患者早期外周血清sCD40L和hs-CRP水平明显升高,提示CD40/CD40L系统与ACS的发生有关,并与炎症因子C反应蛋白协同,对动脉粥样硬化斑块不稳定性起着重要作用。

The clinical research of serum soluble CD40L and high sensitivie C-reactive protein in patients with acute coronary syndrome

AIM:To explore the clinical significance and mechanism of soluble CD40 Ligand(sCD40L) and high sensitive C-reactive protein(hs-CRP) in patients with acute coronary syndrome(ACS).METHODS:A total of 86 consecutive patients with ACS were included in the study,according to the selection criteria for diagnosis of acute coronary syndrome(ACS),86 patients were divided into two groups:normal and the ACS,In all patients,sCD40L and CRP levels were evaluated within 12 h.the incidence of acute cardiovascular events were observed after two months follow-up.RESULTS:The ACS group was obviously higher than control group(P<0.01),AMI group slightly higher than the UA group but had no significant difference(P>0.05).sCD40L and hs-CRP group of cardiovascular events increased more than the normal group.CONCLUSION:Acute coronary syndrome patients with early peripheral serum levels of sCD40L and hs-CRP were significantly increased,suggesting that CD40/CD40L system participate the occurrence of ACS,and the inflammatory factors such as C-reactive protein in collaboration,plays an important role on atherosclerotic plaque instability.