急性冠脉综合征患者血清hsCRP及sCD40L临床特点.docVIP

急性冠脉综合征患者血清hsCRP及sCD40L临床特点 　【摘要】 目的 观察急性冠状动脉综合征(ACS)患者血清超敏C反应蛋白(hsCRP) 和可溶性CD40配体(sCD40L)的变化及临床意义。方法 采用夹心法酶联免疫吸附测定分析(ELISA)及微粒子增强透射免疫分析法分别测定对照组、稳定型心绞痛(SAP)组、ACS组的血清sCD40L和hsCRP水平，并观察经皮冠状动脉介入(PCI)术对其的影响。结果 ①ACS组血清hsCRP 及sCD40L水平均高于SAP 及对照组(Plt;0.01)，SAP组与对照组无统计学差异(Pgt;0.05);②相关分析显示血清sCD40L水平与hsCRP呈正相关(r=0.787，Plt;0.001);③SAP和ACS组PCI术后血清hsCRP、sCD40L水平均较术前显著升高(Plt;0.01)。结论ACS组患者血清hsCRP、sCD40L水平显著增高，提示冠心病的不稳定状态，可能有助于临床识别和预测ACS。 【关键词】 急性冠状动脉综合征;超敏C反应蛋白;可溶性CD40配体;炎症 　　ABSTRACT：Objective To observe the clinical significance of serum highsensitive Creactive protein(hsCRP)and soluble CD40 ligand(sCD40L)levels in patients with acute coronary syndrome(ACS).Methods 49 patients with ACS, 27 patients with SAP,and 15 controls entered this study.The serum levels of sCD40L and hsCRP were measured by enzyme linked immunosorbent assay(ELISA)and particleenhanced immunonephelomerty respectively.Results ① The serum levels of hsCRP and sCD40L were higher in ACS group than those of SAP group and control group (Plt;0.01), while no significant difference was found between SAP group and control group(Pgt;0.05).② The serum level of hsCRP was significantly correlated with that of sCD40L(R=0.787，Plt;0.001).③ In both ACS group and SAP group, the levels of hsCRP and sCD40L after percutaneous transluminal coronary intervention(PCI) were elevated significantly compared with those before PCI (Plt;0.01).Conclusion Significant increase of serum hsCRP and sCD40L levels suggestes the unstable condition of coronary heart disease, and might be considered suitable markers for identifying and predicting ACS. 　　KEY WORDS：Acute coronary syndrome(ACS);hsCRP; soluble CD40 ligand(sCD40L); inflammation 　　炎症反应导致冠状动脉内皮损伤、促使不稳定斑块形成并破裂、引起血栓形成是急性冠状动脉综合征(ACS)发生的重要机制[1]。细胞因子在冠状动脉急性病变的病理过程中起重要促进作用，其中CD40信号转导途经是一种重要调节机制[2]。近年的体内外研究[3]发现 CD40 和CD40配体(CD40L )在动脉粥样斑块中的多种细胞表达、 且 CD40 和 CD40L信号途径介导的一系列生物学效应如分泌细胞因子、黏附分子、基质金属蛋白酶和组织因子等可能参与 ACS 的发生和发展。超敏 C 反应蛋白 (highsensitivity Creactive protein，hsCRP) 被认为是与动脉