急性冠脉综合征患者血浆可溶性Fas配体水平变化及其意义

Change of plasma level of soluble Fas ligand in patients with acute coronary syndrome and its significance

目的:探讨急性冠脉综合征患者血浆可溶性Fas配体(sFasL)水平的变化及其意义。方法:入选急性冠脉综合征患者50例,其中急性心肌梗塞(AMI)30例(AMI组)、不稳定型心绞痛(UAP)20例(UAP组),另有稳定型心绞痛(SAP)患者20例为SAP组,30例健康对照者为健康对照组。采用酶联免疫吸附试验检测各组sFasL水平,并比较其结果。结果:(1)血浆sFasL水平在AMI组[(100.56±30.61)pg/ml]和UAP组[(51.13±23.46)pg/ml]显著高于SAP组[(7.08±1.20)pg/ml]和健康对照组[(6.19±1.11)pg/ml],P均<0.01;(2)病程观察显示AMI患者经皮冠状动脉成形术后3h内血浆sFasL水平迅速下降,此后再次上升,而SAP患者则否;(3)冠状窦内sFasL水平明显高于外周血[(210±40)pg/ml∶(78±21)pg/ml,P<0.05];(4)体外研究表明FasL信使核糖核酸表达在AMI患者离体单核细胞上调,低氧可刺激离体单核细胞sFasL释放。结论:急性冠脉综合征患者sFasL水平显著升高提示Fas/FasL系统活化,可能参与急性冠脉综合征的发病过程。

Objective： To explore change of plasma level of soluble Fas ligand（sFasL） in patients with acute coronary syndrome（ACS）and its significance.Methods： In 50 ACM patients,there were 30 patients with acute myocardial infarction（AMI,AMI group）,20 of unstable angina pectoris（UAP,UAP group）.Another there were 20 patients with stable angina pectoris（SAP,SAP group）,and 30 healthy controls（healthy control group）.Enzyme linked immunosorbent assay（ELISA） was used to measure sFasL levels of each group and the results were compared then.Results：（1） Plasma levels of sFasL of AMI group [（100.56±30.61） pg/ml] and UAP group [（51.13±23.46） pg/ml] were significantly higher than those of SAP group [（7.08±1.20） pg/ml] and healthy control group [（6.19±1.11） pg/ml],P0.01 all;（2） The plasma levels of sFasL of AMI patients quickly decreased 3h after percutaneous coronary arterioplasty,then increased again,which didn′t appear in SAP patients all;（3） sFasL level in coronary sinus was significantly higher than that in peripheral blood [（210±40）pg/ml vs.（78±21）pg/ml,P0.05];（4） Expression of FasL messenger ribonucleic acid upregulated in ex vivo monocytes of AMI patients,and hypoxemia can stimulate release of sFasL from ex vivo monocytes.Conclusion： Level of sFasL increase in patients with acute coronary syndrome,sFasL may participate in the development of acute coronary syndromes.