急性冠脉综合征患者血清sCD40L、TNF-α的变化及相关性

Changes and relations between serum soluble CD40L and TNF-α in patients of actue coronary syndrome

目的探讨血清可溶性CD40配体(sCD40L)与肿瘤坏死因子-α(TNF-α)在急性冠脉综合征(ACS)中变化的意义及相关性。方法急性心肌梗死(AMI)患者45例,不稳定心绞痛(UAP)患者38例及健康体检者40例采用ELISA方法测定sCD40L及TNF-α的血清含量。结果急性冠脉综合征患者血清sCD40L在不稳定心绞痛(UAP)和急性心肌梗死组(AMI)分别为[(2.16±0.84)ng/ml,(2.93±0.99)ng/ml]显著高于健康对照组[(1.25±0.86)ng/ml(P<0.05)]。AMI组血清sCD40L水平高于UAP组,但无统计学意义。急性冠脉综合征患者血清TNF-α在AMI组为[(238.56±34.21)ng/ml]明显高于UAP组[(199.33±30.25)ng/ml(P<0.01)]和健康对照组[(132.25±29.28)ng/ml(P<0.01)]。sCD40L和TNF-α呈显著正相关(r=0.698,P<0.01)。结论急性冠脉综合征患者外周血清sCD40L和TNF-α水平升高,可能与急性冠脉综合征的发生有关,可能是动脉粥样硬化不稳定的标志,sCD40L可能通过促使TNF-α的表达而促发急性冠脉综合征。

Objective To investigate the significance and relations between serum sCD40L and TNF-α in acute coronary syndrone.Methods The study groups included 45 cases of acute myocardial infarction（AMI） ,38 unstable angina （UAP） ,and the control group had 40 healthy subjects, sCD40L and TNF-α levels were measured by Enzyme-linked immunnsorbent assay. Results sCD40L level was significantly higher in patients with acute coronary syndrome[ （2.16 ± 0.84） ng/ml and （2.93 ± 0.99） ng/ml in U AP and AMI group, respectively ] than in control group[ （1.25 ± 0.86 ）ng/ml （ P 〈 0.05） ]. sCD40L level was higher in AMI group than in UAP group.But there was no statistical significance between them. The serum TNF-α level was obviously higher in patients with acute coronary syndrome[ （238.56 ± 34.21） ng/ml in AMI group] than in UAP group [ （ 199.33 ± 30.25） ng/ml （ P 〈 0.01 ） ] and control group [ （ 132.25 ±29.28） ng/ml （ P 〈 0.01 ） ]. Serum sCD40L was significantly correlated with TNF-α （ r = 0. 698, P 〈 0.01 ）. Conclusion Serum sCD40L and TNF-α levels were elevated in acute coronary syndrome, which maybe relate to the oeeuranee of ACS and may serve as a potential marker of plaque stability.