Stanford A型主动脉夹层患者中可溶性CD40配体表达及炎性反应

SCD40 ligand expression and inflammatory response in acute aortic dissection patients

目的探讨可溶性CD40配体在Stanford A型主动脉夹层(Stanford A type aortic dissection,STAAD)中的表达及其在主动脉夹层中的炎症反应。方法本研究于2016年8月至2017年2月,共纳入STAAD患者95例[男67例、女28例,年龄(48.33±12.19)岁]和健康志愿者120例[男94例、女26例,年龄(48.64±10.13)岁]的血液样本。主动脉夹层患者于术前1 h取血,健康志愿者于肘静脉取血。所有STAAD患者均在CTA明确诊断,并排除马方综合征等患者。血液样本行酶联免疫吸附(ELISA)检测SCD40L、血管细胞粘附分子-1、E选择素、白细胞介素-1β、白介素-6、肿瘤坏死因子-α等。结果与健康志愿者对比,STAAD组SCD40L[(26.87±5.50)ng/ml vs.(13.39±4.03)ng/ml,P<0.001]有明显升高。E选择素[(116.62±25.24)ng/ml vs.(77.05±14.30)ng/ml,P<0.001],血管细胞粘附分子-1(P<0.001),肿瘤坏死因子-α[(55.35±9.12)pg/ml vs.(37.33±5.61)pg/ml,P<0.001],白介素-1β[(62.12±13.37)pg/ml vs.(48.68±9.86)pg/ml,P<0.001],白介素-6[(499.54±90.45)pg/ml vs.(422.44±34.00)pg/ml,P<0.001]明显升高。结论 SCD40L在Stanford A型主动脉夹层患者中的表达升高以及主动脉夹层患者中血管内皮损伤导致的炎症反应明显升高。

Objective To investigate the relationship of cluster of differentiation 40 L(CD40 L) between inflammatory response mediated by vascular endothelial injury and Stanford A type aortic dissection(STAAD). Methods In this study from August 2016 to February 2017, a total of 215 blood samples from 95 STAAD patients(67 males and 28 females aged 48.33±12.19 years) and 120 healthy volunteers(94 males and 26 females aged 48.64±10.13 years) were collected. The patients with aortic dissection were taken blood 1 hour before the operation and the healthy volunteers were taken blood from the elbow vein. All STAAD patients were diagnozed by computed tomography angiography(CTA) and patients with Marfan syndrome were excluded. Blood samples were tested by enzyme-linked immunosorbent assay(ELISA) for CD40 L, vascular cell adhesion molecule(VCAM-1), E-selectin, interleukin-1(IL-1) beta, IL-6, tumor necrosis factor-alpha(TNF-α) and so on. Results Compared with the healthy population, the level of SCD40 L(26.87±5.50 ng/ml vs. 13.39±4.03 ng/ml, P<0.001) in the STAAD patients was significantly higher. E-Selectin(116.62±25.24 ng/ml vs.77.05±14.30 ng/ml, P<0.001), VCAM-1(P<0.001), TNF-α(55.35±9.12 ng/ml vs. 37.33±5.61 pg/ml, P<0.001),IL-1β(62.12±13.37 ng/ml vs. 48.68±9.86 pg/ml, P<0.001),IL-6(499.54±90.45 ng/ml vs. 422.44±34.00 pg/ml, P<0.001)significantly increased. Conclusion The increased expression of SCD40 L in STAAD patients and the inflammatory reaction induced by endothelial injury in aortic dissection patients are obvious.