血清可溶性OX40配体和高敏C反应蛋白对冠状动脉事件的预测价值

Value of measuring levels of serum soluble OX40 ligand and hs-CRP in predicting coronary artery events

目的观察冠心病患者血清可溶性OX40配体(sOX40L)和高敏C反应蛋白(hs-CRP)水平的变化,探讨sOX40L和hs-CRP与冠状动脉粥样斑块稳定性的关系。方法选择住院患者200例,依据不同疾病分为3组:急性冠状动脉综合征(ACS)组(90例),稳定性心绞痛(SAP)组(60例),对照组(50例)。采用透视免疫比浊法检测hs-CRP;酶联免疫吸附法检测sOX40L。所有患者均行冠状动脉造影,计算冠状动脉病变形态积分,并与sOX40L,hs-CRP水平进行相关分析。结果 ACS组sOX40L及hs-CRP水平显著高于SAP组和对照组(P<0.05),SAP组与对照组间差异无统计学意义(P>0.05);ACS组冠状动脉狭窄病变形态积分明显高于SAP组和对照组(P<0.05),SAP组与对照组间病变积分差异无统计学意义(P>0.05);ACS患者sOX40L和hs-CRP水平与冠状动脉造影狭窄病变形态积分有明显相关性(P<0.05);sOX40L与hs-CRP呈显著正相关(r=0.48,P<0.01)。结论冠心病患者血清sOX40L、hs-CRP水平升高可能提示斑块不稳定;血清sOX40L、hs-CRP水平可以有效判断冠状动脉病变程度,预测急性冠状动脉事件的发生。

Objective To explore the relationship between sOX40L,high sensitivity C reactive protein（hs-CRP） and stability of coronary atherosclerotic plaque in patients with coronary heart disease（CHD）. Methods A total of 200 patients were divided into three groups：acute coronary syndrome（ACS） group, stable angina pectoris（SAP） group and control group. The plasma sOX40L was determined with EI,ISA and hs CRP was measured with scatter nephelometry in all subjects. All patients underwent coronary angiography（CAG） and angiographic coronary stenosis morphology score was calculated. Results The serum levels of sOX40L and hs-CRP in ACS group were significantly higher than those in SAP and control groups （P 〈0.05） ,but there was no significant difference between SAP group and control group. The score of angiographic morphology of coronary lesions in ACS group was significantly higher than that in SAP and control groups （P〈0.05） ,but there was no significant difference between SAP group and control group. The levels of sOX40L and hs-CRP were correlated with the coronary stenosis severity score （P d0.05）. Correlation analysis indicated that the level of sOX40L was positively correlated with hs-CRP （P 0. 05）. Conclusion The increased serum levels of sOX40L and hs-CRP in ACS may enhance the inflammation,aggravate the development of atherosclerosis and mediate the rupture of instable plaque. They can serve as valuable markers for evaluating the degree of coronary artery pathology and predicting the occurrence of coronary artery events.