急性冠脉综合征患者循环血中OX40L高表达的临床价值.doc

急性冠脉综合征患者循环血中OX40L高表达的临床价值 　　作者：陈广华,严金川　　作者单位：江苏大学附属医院 心内科，江苏 镇江 212001 　　【摘要】 目的 探讨急性冠脉综合征(ACS)患者外周血淋巴细胞OX40配体(OX40L)表达及血清可溶性OX40L(sOX40L)水平变化的临床意义。方法 应用间接免疫荧光流式细胞术和ELISA分别对正常对照组 20例、稳定型心绞痛(SA)组20例、ACS组40例的外周血淋巴细胞OX40L表达及血清sOX40L水平进行检测，免疫透射比浊法检测血清C反应蛋白(CRP)。结果 ACS组外周血淋巴细胞OX40L表达明显高于SA组和对照组(P0.01)，SA组与对照组相比差异无统计学意义(P0.05);ACS组血清sOX40L水平明显高于SA组和对照组(P0.01)，SA组与对照组相比差异无统计学意义(P 0.05);ACS组血清CRP 水平明显高于SA组和对照组(P0.01)，SA组与对照组相比差异无统计学意义(P 0.05)。血清sOX40L水平与CRP呈正相关(r =0.79，P0.001)，血清sOX40L水平与冠脉病变复杂狭窄数呈正相关(r =0.72，P 0.001)。结论 ACS患者外周血淋巴细胞OX40L表达及血清sOX40L水平均明显升高，提示sOX40L在ACS的发生和发展中具有重要作用，可作为预测ACS的新指标。 　　【关键词】 OX40配体,动脉粥样硬化,急性冠脉综合征 　　Abstract：Objective To investigate the clinical implications of OX40 ligand (OX40L) on peripheral blood lymphocytes and changes in serum soluble OX40L(sOX40L) in patients with acute coronary syndromes(ACS).Methods Twenty control and 60 patients，including 20 with stable angina (SA)，40 with ACS enrolled in this study.Expression of OX40L on peripheral blood lymphocytes was analyzed by flow cytometry and sOX40L levels were measured by ELISA.Creactive protein (CRP) in serum was determined by immunological turbidity kit.Results Expression of OX40L on peripheral blood lymphocytes in ACS patients were significantly higher than those in SA patients and controls (P0.01)，while no significant difference was found between SA patients and controls(P0.05).The serum levels of sOX40L in ACS patients were significantly higher than those in SA patients and controls (P0.01).SOX40L levels in SA patients showed no significant increase when compared to controls.The levels of CRP in ACS patients were higher than those in SA patients and controls (P0.01)，and the level of CRP had a positive correlation with sOX40L level(r=0.79， P0.01).A significant correlation was observed between sOX40L serum concentration and the number of complex lesions(r=0.72， P0.01).Conclusion Expression of OX40L on peripheral blood lymphocytes and sOX40L serum concentration are elevated