可溶性CD40L水平对急性脑梗死患者颈动脉粥样硬化斑块稳定性的影响

Stability of soluble CD40L levels of plaque for patients with acute cerebral infarction carotid atherosclerosis

目的探讨可溶性CD40L水平对急性脑梗死患者颈动脉粥样硬化斑块稳定性的影响。方法选取急性脑梗死患者69例(观察组),以健康体检者28例为对照组,应用酶联免疫法测量血清可溶性CD40L水平,并行彩色多普勒检查,测定颈动脉内-中膜厚度(IMT)、有无斑块及计算Crouse积分,比较2组颈动脉粥样硬化斑块、血清可溶性CD40L水平,根据超声结果分为稳定斑块组、不稳定斑块组,比较2组血清可溶性CD40L水平,分析可溶性CD40L水平与颈动脉粥样硬化斑块稳定性的关系。结果观察组血清可溶性CD40L浓度(7.97±2.42)μg/L,高于对照组(P<0.05)。观察组检出粥样硬化斑块91个,其中不稳定斑块62个(68.13%)。不稳定斑块组血清可溶性CD40L水平高于稳定斑块组(P<0.05)。观察组IMT增厚、Crouse积分高于对照组(P<0.05)。血清可溶性CD40L水平与IMT、Crouse积分呈正相关。结论急性脑梗死患者血清可溶性CD40L水平明显升高,可能为预测缺血性脑血管事件的重要指标,可溶性CD40L越高,颈动脉粥样硬化斑块的稳定性越差,通过影响斑块稳定性参与了急性脑梗死的发生。

Objective To investigate the influence of soluble CD40L levels for patients with acute carotid atherosclerotic plaque stability, and analyze the predicted value of soluble CD40L for cerebral infarction. Methods Patients with acute cerebral infarction from April 2011 to June 2014 in hospital were selected as trail group, and healthy people were selected as control group in the same period. Soluble CD40L levels of all subjects were detected by ELISA method, and internal carotid artery- media thickness IMT, plaque formation and integral calculation Crouse of all subjects were detected by color Doppler. Carotid atheroselerotic plaque, serum levels of soluble CD40L were compared between two groups. Patients with acute cerebral infarc- tion were divided into stable plaque group and unstable plaque group by ultrasound results, and two groups＇ patients＇ soluble CD40L levels were compared, the relationship between soluble CD40L levels and carotid atherosclerosis plaque stability was analyzed. Results Serum soluble CD40L concentration level of trail group was （7.97±52.42）mg/L, and trail group patients＂ ser- um soluble CD40L concentration levels was higher than control group （P,0.05）, 91 atherosclerotic plaques were detected in tail group patient, 62 plaques （68.13%） were unstable plaque, accounting for 68.13%. Serum soluble CD40L levels of unsta- ble plaque patients were higher than stable plaque patients （P〈0.05）; IMT increased, Crouse points of trail patient were higher than control group patients （P〈0.05）. Serum soluble CD40L level and IMT, Crouse points were positively correlated. Conclusion Serum sCD40L level in patients with acute cerebral infarction is significantly higher than normal health, which may be the prediction of ischemic cerebrovascular events important indicator.