慢性心力衰竭患者体内CD40L高表达的临床意义

The clinical implications of increased CD40 ligand expression in patients with chronic heart failure

目的观察慢性心力衰竭(简称慢性心衰)患者体内CD40L表达是否失调,探讨CD40L表达与脑钠肽(BNP)水平的相关性。方法采用间接免疫荧光流式细胞术和ELISA法分别对正常对照组(30例)及140例慢性心衰患者的血小板CD40L表达及血清可溶性CD40L水平进行检测。BNP采用放射免疫法测定。结果慢性心衰患者血小板CD40L表达[(39.4±13.7)MFI]及血清可溶性CD40L水平[(23.8±8.7)ng.ml-1]明显增高,且血小板CD40L表达及血清CD40L水平与纽约心脏病学会(NYHA)的心功能分级及BNP水平呈正相关,与左室射血分数(LVEF)呈负相关。结论CD40L表达水平的增高可能参与了慢性心衰的发生、发展。

Objective To investigate whether CD40 ligand （CD40L） expression was disordered and the correlation between CD40 ligand and brain natriuretic peptide （BNP） in patients with chronic heart failure （CHF）. Methods Thirty normal controls and 140 patients with CHF were observed. The expression of CD40L of platelets was analyzed by indirect-immunofluorescence flow cytometry, and the serum soluble CD40L （sCD40L） level was detected by a commercially available enzyme-linked immunosorbent assay （ELISA）. BNP was measured by radioimmunoassay. Results Our results provided that patients with CHF showed a significant increased expression of CD40L[ （39.4±13.7） MFI] of platelets and sCD40L levels[ （23.8 ± 8.7） ng·ml^-1 ]. CD40L expression of platelets and sCD40L levels significant positively correlated with New York Heart Association （NYHA） functional class and BNP levels in patients with CHF. But it negatively correlated with left ventrieular ejection fraction （LVEF）. Conclussions The patients with CHF show upregulation expression of CD40L system,which may create a pathogenic role in the development and progression of CHF.