尿激酶对急性冠脉综合征患者可溶性白细胞分化抗原40配体表达的影响

Influence of urokinase on expression of soluble CD40 ligand in patients with acute coronary syndrome

目的:探讨尿激酶对急性冠脉综合征(ACS)患者可溶性白细胞分化抗原40配体(sCD40L)表达的影响。方法:选择2013年8月到2015年8月在我院进行诊治的ACS患者94例作为研究对象,根据随机数字表法被随机均分为常规治疗组和尿激酶组(在常规治疗组基础上接受小剂量尿激酶静滴)。测量比较两组治疗前、后sCD40L和心肌肌钙蛋白T(cTnT)水平,并比较两组临床疗效和主要不良心血管事件(MACE)发生率。结果:与治疗前比较,两组治疗后sCD40L和cTnT水平均显著降低(P均<0.01);与常规治疗组比较,尿激酶组治疗后sCD40L[(2.92±0.36)ng/ml比(2.58±0.18)ng/ml]和cTnT水平[(0.10±0.02)μg/L比(0.04±0.01)μg/L]降低更显著,P依次=0.013,0.001。与常规治疗组比较,尿激酶组治疗总有效率(76.6%比95.7%)显著升高,6个月内MACE发生率(34.0%比4.3%)显著降低,P均<0.01。结论:尿激酶能显著抑制急性冠脉综合征患者可溶性白细胞分化抗原40配体的表达,减少心肌肌钙蛋白T的释放,提高疗效,防止主要不良心血管事件的发生。

Objective： To explore influence of urokinase on expression of soluble CD40 ligand （sCD40L） in patients with acute coronary syndrome （ACS）. Methods： A total of 94 ACS patients diagnosed and treated in our hospital from Aug 2013 to Aug 2015 were selected. According to random number table, they were randomly and equally divided into routine treatment group and urokinase group （received small dose urokinase intravenous drip based on routine treatment group）. Levels of sCD40L and cardiac troponin T （eTnT） before and after treatment, therapeutic effect and incidence rate of major adverse cardiovascular events （MACE） were measured and compared between two groups. Results： Compared with before treatment, there were significant reductions in levels of sCD40L and eTnT in both groups after treatment, P〈0.01 all; compared with routine treatment group after treatment, there were significant reductions in levels of sCD40L [ （2.92 ± 0.36） ng/ml vs. （2.58 ± 0.18） ng/ml] and eTnT [ （0.10 ± 0.02） μg/L vs. （0.04 ± 0.01） μg/L] in urokinase group, P = 0. 013, 0.001 successively . Compared with routine treatment group, there was significant rise in total effective rate （76.6% vs. 95.7%）, and significant reduction in incidence rate of MACE （34.0% vs. 4.3%） within six months in urokinase group （P〈0.01 both）. Conclusion： Urokinase can significantly inhibit expression of sCD40L and reduce release of eTnT, and improve therapeutic effect, and prevent major adverse cardiovascular events in patients with acute coronary syndrome.