急性冠状动脉综合征患者血浆CD40L变化及其与可溶性血管黏附分子关系

The study of plasma CD40L level and it's correlation to the soluble vascular adhesion molecules in acute coronary syndrome

目的 观察冠心病不同类型患者中CD4 0L水平的变化及其与血管性黏附分子之间的关系 ,进一步探讨急性冠状动脉 (冠脉 )综合征临床识别和预测的炎症指标。方法 采用酶联免疫吸附法测定血清可溶性CD4 0L(sCD4 0L)、可溶性细胞间黏附分子 1和血管细胞黏附分子 1浓度。结果 急性冠脉综合征患者sCD4 0L水平 (3 17± 2 84 )ng/ml显著高于对照 (1 19± 1 0 5 )ng/ml,P <0 0 1和稳定性冠心病患者 (1 6 1± 1 4 6 )ng/ml,P <0 0 5。sCD4 0L水平与可溶性细胞间黏附分子 1呈显著正相关 (r=0 4 13,P <0 0 1)。sCD4 0L水平受甘油三酯 (r =0 2 3,P =0 0 4 1)、载脂蛋白B(r =0 2 4 8,P =0 0 2 7)及高密度脂蛋白胆固醇等因素影响 (r=- 0 2 5 3,P =0 0 2 4 )。结论 本研究结果表明急性冠脉综合征患者外周血sCD4 0L水平升高 ,提示其可能与急性冠脉综合征的发生有关 ,是动脉粥样硬化斑块不稳定的标志。CD4 0L可能通过上调黏附分子表达而促发急性冠脉综合征。

Objective To investigate the difference of sCD40L level in different subtype of coronary heart disease and it′s relationship with vascular adhesion molecules and to explore the potential predicting factor for the acute coronary syndrome (ACS) Methods Enzyme linked Immunosorbent Assay was used to measure the plasma sCD40L, soluble intercellular adhesion molecule 1, and soluble vascular cell adhesion molecule 1 Results sCD40L level was significantly higher in patients with ACS [(3 17±2 84) ng/ml] than in those of the control [(1 19±1 05) ng/ml, P< 0 01] and in patients with stable coronary heart disease [(1 61±1 46) ng/ml, P <0 05] sCD40L level was positively correlated with soluble intercellular adhesion molecule 1 ( r =0 413, P <0 01) sCD40L level was also significantly related to TG ( r =0 23, P =0 041), apoB( r =0 248, P =0 027), and HDL C (r=-0 253, P =0 024) Conclusion The elevated sCD40L level in ACS suggested the possible relation of CD40L to the pathogenesis of ACS, which may save as a potential marker of plaque unstability The positive correlation between CD40L and adhesion molecules may indicate the possible mechanism by which CD40L facilitates the ACS via up regulating the adhesion molecules expression