血糖水平对急性脑梗死患者血清可溶性CD40配体水平的影响

Correlation of the levels of sCD40 L and glucose with acute cerebral infarction

目的 对比不同血糖水平急性脑梗死患者外周血清中可溶性CD40配体（sCD40 L）水平,并探讨其与血糖水平的相关性.方法 选择急性脑梗死患者98例,根据血糖水平将其分为：糖耐量正常组、糖耐量异常组和2型糖尿病组.经超声检测颈动脉内中膜厚度及斑块情况并行Crouse斑块积分,酶联免疫吸附法检测外周血清中sCD 40L水平.结果 3组间血清sCD40L、IMT、Crouse积分比较差异有显著性（P＜0.05）.相关分析显示,血清sCD40L与血糖水平（r=0.272,P＜0.05）、IMT（r=0.651,P＜0.01）、Crouse积分（r=0.733,P＜0.01）均呈显著正相关.结论 糖尿病患者CD40L表达明显增高,血清sCD40L促进2型糖尿病患者颈动脉粥样硬化,其水平升高可能反应颈动脉粥样斑块的不稳定性.继发脑血管病的过程中可能启动或者介导了CD40/CD40L信号途径.

Objective By comparing the levels of sCD4oL in the serum of the acute cerebral infarct patients with different degrees of glucose to investigate the correlation of the levels of sCD40 L and glucose. Methods 98 patients with acute cerebral infarction were divided into NGT, IGT and T2DM group according to the OGTT results. Levels of sCD40L in serum were detected by enzyme-linked immunosorbent assay. Intima-media thickness（ IMT）, plaque eehogenicity and morpholog were detected by color Doppler ultrasound. Results There were significant differences in sCD40L,IMT,and Crouse score among the three groups（ P 〈 0.05 ）. The levels of serum sCD40 L were positively related with IMT （ r = 0.651, P 〈 0.01 ）, Crouse score（r =0.733,P〈0.01）,and degree of glueose（r =0.272,P〈0.05）. Conclusions In type 2 diabetes patients, high circulating sCD40 L levels may promote carotid atherosclerosis and carotid plaque instability. Cerebral vascular disease process may start or mediated by CD40/CD40L signaling pathways.