超声检查肱动脉FMD和sCD40L对急性冠状动脉综合征的预测价值

Value of brachial artery FMD and sCD40L in predicting acute coronary syndrome

目的探讨超声检查肱动脉血流介导性舒张(FMD)和血清可溶性细胞分化抗原40配体(sCD40L)对急性冠状动脉综合征(ACS)的预测价值。方法随机入选39名健康志愿者、39例稳定性心绞痛患者(SA组)和79例急性冠状动脉综合征(ACS)患者。ACS患者包括不稳定性心绞痛患者49例(UA组),急性心肌梗死患者30例(AMI组)。用超声检查肱动脉FMD,并用ELISA法检测血清sCD40L的含量。研究ACS患者肱动脉FMD和血清sCD40L的变化。用Pearson相关性分析ACS患者肱动脉FMD与血清sCD40L水平的关系。结果肱动脉FMD正常对照组(9.52±2.54)%,SA组(5.35±1.24)%,UA组(3.32±1.41)%,AMI组(3.26±1.32)%,ACS患者肱动脉FMD下调(P<0.05)。血清sCD40L正常对照组(1.21±0.31)ng/ml,SA组(4.12±0.98)ng/ml,UA组(12.86±2.67)ng/ml,AMI组(13.95±2.83)ng/ml,ACS患者血清sCD40L升高(P<0.05)。ACS患者肱动脉FMD与血清sCD40L水平呈负相关,r=-0.708,P=0.000。结论超声发现肱动脉FMD下调,血清sCD40L升高,对ACS有预测价值。

Objective To investigate the predictive value of ACS by brachial artery FMD and sCD 40L. Methods Thirty-nine healthy volunteers（control group）, 39 patients with stable angina pectoris（SA group） and 79 patients with acute coronary syndrome （ACS）,including 49 patients with unstable angina pectoris （UA group） and 30 patients with acute myocardial infarction （AMI group）, were radomly selected.The patients with ACS were detected the brachial artery FMD by ultrasonic testing and the serum sCD 40L by ELISA.Relation of brachial artery FMD and serum sCD40L of ACS patients were analyzed by using Pearson correlation analysis .Results Compared with control group and SA goup , the brachial artery FMD decreased in UA group and AMI group （ 9.52 ±2.54 ）%（ control group） vs （5.35 ±1.24）%（SA group） vs （3.32 ±1.41）% （UA group） vs （3.26 ±1.32）%（AMI group）, （P〈0.05）.Compared with control group and SA goup , the serum sCD40L increased in UA group and AMI group （1.21 ± 0.31）ng/ml（control group） vs （4.12 ±0.98）ng/ml（SA group） vs （12.86 ±2.67）ng/ml （UA group） vs （13.95 ± 2.83）ng/ml（AMI group）, （P〈0.05）.Pearson correlation analysis indicted that the brachial artery FMD was nega-tively associated with the level of serum sCD40L in ACS patients （r=-0.708,P=0.000）.Conclusion The down-regulation of brachial artery FMD by ultrasound findings and upregulation of serum sCD 40L have predictive value for the occurrence of ACS .