急性冠状动脉综合征患者血清sCD40L升高的临床价值

目的观察冠心病不同类型患者中可溶性CD40L(sCD40L)水平的变化及其与白细胞介素-6(IL-6)和白细胞介素-1β(IL-1β)之间的关系,进一步探讨急性冠状动脉综合征(ACS)临床识别和预测的炎症指标。方法采用酶联免疫吸附法测定血清可溶性CD40L浓度,采用放免方法测定IL-6和IL-1β浓度。结果急性心肌梗死(AMI)患者sCD40L水平(4.923±3.41)ng/ml]和不稳定型心绞痛(UAP)患者sCD40L水平(5.387±3.04)ng/ml]显著高于稳定型心绞痛(SAP)(2.856±2.34)ng/ml,P<0.05]和对照组患者(2.221±2.42)ng/ml,P<0.01]。ACS患者sCD40水平与IL-6呈正相关(r=0.49,P=0.008),与IL-1β无相关性(r=0.258,P=0.183),而SAP和对照组患者sCD40L与IL-6、IL-1β无相关性。同时ACS患者sCD40L水平与低密度脂蛋白有显著相关性(r=0.471,P=0.011)。结论ACS患者血清sCD40L与IL-6、IL-1β水平升高,提示其可能与ACS发生有关,是动脉粥样硬化和斑块不稳定的标志。

Value of serum sCD40L level elevated in acute coronary syndrome

Objective To investigate the difference of sCD40L level in different subtype of coronary heart disease and its relationship with interleukin-6 and interleukin-1β, and to explore the potential predicting factor for the acute coronary syndrome. Methods Enzyme-linked immunosorbent assay was used to measure the serum sCD40L, and the serum interleukin-6 and interleukin-1β were measured by radioimmunoassay. Results sCD40L level was significantly higher in patients with acute myocardial infarction(4.923±3.41ng/ml)and unstable angina(5.387±3.04ng/ml)than that of stable angina(2.856±2.34 ng/ml, P<0.05)and control(2.221±2.42 ng/ml, P<0.01). sCD40L level was positively correlated with interleukin-6(r=0.49,P=0.008)and no correlated with interleukin-1β(r=0.258,P=0.183). The level of sCD40L in patients with stable angina and in control was not correlated with the level of interleukin-6 and interleukin-1β at the same time. sCD40L level was also significantly related to LDL(r=0.471,P=0.011). Conclusion The elevated level of sCD40L and IL-6,IL-1β in ACS suggested the possible relation to the pathogenesis of ACS, which may be a potential inflammatory marker of plaque instability.