急性冠脉综合征CD40-CD40L昼夜节律的变化

Circadian variation of CD40-CD40L system in patients with acute coronary syndrome

目的观察血小板表达的白细胞分化抗原40及其配体系统(CD40-CD40L)在急性冠脉综合征(ACS)患者昼夜节律变化规律及其临床意义。方法选择40例正常对照组,40例不稳定心绞痛(UAP),30例急性心肌梗死(AMI)患者,在05∶00、10∶00分别抽取肘静脉血2ml,采用流式细胞仪测定血小板CD40、CD40L水平的变化。结果①UAP组和AMI组血小板CD40、CD40L较正常对照组高(P<0.05);②UAP组和AMI组05∶00CD40L较10∶00高(P<0.05),对照组两个时间点之间无显著差异;③3组血小板CD40两个时间点均无显著差异。结论ACS血小板表达的CD40及CD40L增高,且血小板CD40L呈现出昼夜节律的变化。

AIM To investigate whether there is a significant circadian variation of CD40 antigens and CD40 ligands （CD40Ls） on platelets in patients with acute coronary syndrome （ACS）. METHODS The expressions of CD40 and CD40L on platelets at the time point of 05 ： 00 and 10 ： 00 were determined in 40 patients with unstable angina pcetoris （UPA）, 30 patients with acute myocardial infarction （AMI） and in controls （ n = 40） by flow cytometry. RESULTS The expressions of CD40 and CD40L on platelets in UPA and AMI patients were significantly higher than those in controls （P 〈 0.01 ）. The CD40L levels at 05 ： 00 in UPA and AMI patients significantly increased compared to the levels at 10 ： 00 （P 〈 0. 001 ） but no significant difference of CD40L on platelets was found in controls between 05：00 and 10 ： 00. The CD40 expression on platelets at 05 ： 00 was higher than that at 10 ： 00, but no significant difference was found between controls and patients with ACS. CONCLUSION Patients with ACS show significantly increased coexpression of CD40 system and circadian variation at CD40L concentration on platelets.