CD40配体高表达与不稳定型心绞痛之间的关系

为了探讨不稳定型心绞痛患者外周血单核细胞表达CD40配体及血清可溶性CD40配体变化的临床意义。应用间接免疫荧光流式细胞术和双抗夹心酶联免疫测定法分别对正常对照组 16例、稳定型心绞痛 2 0例、不稳定型心绞痛 2 0例患者血单核细胞表达CD40配体及血清可溶性CD40配体水平进行检测。并观察血清可溶性CD40配体与冠状动脉病变程度的关系。结果发现 ,(1)不稳定型心绞痛组血单核细胞表达CD40配体明显较稳定型心绞痛组和对照组高 (P <0 .0 1) ,稳定型心绞痛组与对照组相比无差异 (P >0 .0 5 )。 (2 )不稳定型心绞痛组血清可溶性CD40配体水平明显较稳定型心绞痛组和对照组高 (P <0 .0 1) ,而稳定型心绞痛组与对照组相比亦有明显差异 (P <0 .0 5 )。 (3)经皮冠状动脉腔内成形术后血清可溶性CD40配体明显高于术前 (P <0 .0 1) ,但血单核细胞表达CD40配体无差异 (P >0 .0 5 )。 (4 )血清可溶性CD40配体水平与冠状动脉病变的复杂狭窄数相关 (r=0 .5 4,P <0 .0 1) ,而与狭窄的程度和范围无关。此结果提示 ,血清可溶性CD40配体升高对冠状动脉斑块的不稳定或破裂起重要作用 ,且可能是冠状动脉病变的活动性标志物。

The Relation of High Expression of CD40 Ligand with Unstable Angina

Aim To investigate the clinical implications of the expression of CD40 ligand (CD40L) on peripheral blood monocytes and sera soluble CD40L (sCD40L) changes in patients with unstable angina. Methods 16 normal controls and 40 patients including 20 with SA(8 patients by PTCA), 20 with UA entered in this study. The expression of CD40L on monocytes was analyzed by indirect-immonofluorescence flow cytometry and sera sCD40L levels were measured by ELISA. Results (1) The expression of CD40L on monocytes in UA were higher compared with SA and controls (P<0.01), while no significant difference was found between SA and controls(P>0.05). (2) Patients with UA had significantly raised sCD40L sera levels when compared with patients with SA and controls(P<0.01). Values also differed significantly between patients with SA and controls. (3) PTCA induced a marked rise in sCD40L levels in all patients, while the expression of CD40L on monocytes showed no significantly difference between patients with PTCA before and after. (4) A significant correlation was observed between sCD40L sera concentrations and the number of complex lesions(r=0.54, P<0.01). sCD40L, however, was not significantly associated with disease extent and range. Conclusions The enhanced level of serum soluble CD40L may play an important role in coronary plaque instability and disruption, and may represent a marker of coronary disease activity.