急性冠状动脉综合征患者血小板CD40L表达及其临床意义

Variation of CD40L level on platelet and its clinic significance in acute coronary syndrome

目的:探讨急性冠状动脉综合征(ACS)患者血小板CD40L表达的临床意义及其与血浆高敏C反应蛋白(hs-CRP)的关系。方法:收集稳定型心绞痛患者17例、ACS20例、正常对照15例,所有病例均行冠状动脉造影,采用流式细胞技术检测血小板CD40L的表达,采用免疫增强的透视比浊法检测血浆hs-CRP水平。结果:ACS组血小板CD40L的平均荧光强度(17.26±7.62)显著高于稳定型心绞痛组(10.81±2.94,P<0.01)和正常对照组(8.78±4.13,P<0.01)。ACS组血浆hs-CPR水平(8.11±6.67)mg/L显著高于稳定型心绞痛组[(2.79±1.24)mg/L,P<0.01]和正常对照组[(1.98±1.29)mg/L,P<0.01]。冠心病患者血小板CD40L及血浆hs-CRP与冠状动脉病变支数无相关性。冠心病患者血小板CD40L与血浆TC呈正相关(r=0.289,P<0.05)。与血浆hs-CPR、HDL、LDL、TG无相关性。结论:ACS患者血小板CD40L、血浆hs-CRP水平明显增高,血小板CD40L可能是反映斑块稳定性的指标之一。

Objective：To elucidate the clinical significance of the CD40L expression on platelet in acute coronary syndrome（ACS） and the relation between platelet CD40L level and circulating level of high-sensitivity C-reactiveprotein （ hs- CRP ）. Method ： This is a cross-sectional study. All patients who were taken Coronary angiography were divided into three groups： 15 patients in the control group with negative results in coronary, 17 patients in stable angina pectoris （SAP） group, 20 patients in ACS group. Flow-cytometry technology was used to measure the CD40L level on platelet and Particle enhanced immunoturbidimetric assay was used to measure the plasma hs- CRP level. Result：CD40L level on platelet was significantly higher in patients with ACS （17.26 ± 7.62MFI） than that in control group（8. 78±4.13MFI, P〈0.01） and in patients with SAP （10. 81±2.94MFI, P〈0. 01）. Plasma hs-CRP level was significantly higher in patients with ACS （8.11 ± 6.67 mg/L） than that in control group （1. 98±1.29 mg/L,P〈0. 01） and in patients with SAP （2. 79±1.24 mg/L, P〈0.01）. CD40L level on platelet and plasma hs-CRP level had no correlation with the number of lesion vessels in patients with coronary heart dis- ease. CD40L level on platelet had significantly positive correlation with plasma total cholesterol （r = 0. 289, P = 0. 037）. CD40L had no correlation with plasma hs-CRP, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol. Conchlsion：CD40L level on platelet and hs-CRP level in plasma were higher in patients with ACS than those in SAP. CD40L level on platelet may be a marker indicating unstable plaque.