血清可溶性CD40配体与急性脑梗死患者颈动脉斑块的关系

目的 探讨血清可溶性CD40配体（sCD40L）水平与急性脑梗死患者颈动脉粥样硬化斑块的关系。方法 选取2018年5月至2019年5月在中国医科大学附属盛京医院神经内科住院的急性脑梗死患者108例。根据颈部动脉超声结果分为无斑块组和斑块组，斑块组根据斑块性质进一步分为稳定斑块组和不稳定斑块组。应用酶联免疫吸附法（ELISA）测定血清sCD40L水平；分析血清sCD40L水平与颈动脉粥样硬化斑块的关系。结果 颈动脉斑块组患者高血压（P=0.026）、空腹血糖（P=0.045）、三酰甘油（P=0.027）、低密度脂蛋白胆固醇（LDL-c）（P=0.005）和sCD40L水平（P<0.001）均高于无斑块组。高血压（OR=2.598，P=0.028）、LDL-C（OR=4.247，P=0.006）和sCD40L水平（OR=1.079，P=0.009）是急性脑梗死患者存在颈动脉粥样硬化斑块的危险因素。颈动脉不稳定斑块组患者高血压（P=0.031）、白细胞计数（P=0.002）、低密度脂蛋白胆固醇（P=0.003）和sCD40L水平（P<0.001）均高于稳定斑块组。不稳定颈动脉斑块组患者，高血压（OR=2.918，P=0.033）和sCD40L水平（OR=2.712，P<0.001）是急性脑梗死患者颈动脉斑块不稳定性的危险因素。结论 急性脑梗死患者血清sCD40L水平的升高与颈动脉粥样硬化斑块的发生和发展相关，亦与颈动脉斑块的不稳定性相关。

Association of the serum level of soluble cluster of differentiation 40 ligand with carotid plaque in patients with acute cerebral infarction

Objective To investigate the association of the serum level of soluble cluster of differentiation 40 ligand (sCD40L) levels with carotid atherosclerotic plaque in patients with acute cerebral infarction.Methods A total of 108 patients with acute cerebral infarction who were admitted to Department of Neurology, Shengjing Hospital of China Medical University, from May 2018 to May 2019 were enrolled. According to the findings of carotid artery ultrasound, they were divided into non-plaque group and plaque group, and the plaque group was further divided into stable plaque group and unstable plaque group according to the nature of plaque. ELISA was used to measure the serum level of sCD40L, and the association between serum sCD40L level and carotid atherosclerotic plaque was analyzed.Results Compared with the non-plaque group, the plaque group had a significantly higher proportion of patients with hypertension (P=0.026), as well as significantly higher levels of fasting blood glucose (P=0.045), triglyceride (P=0.027), low-density lipoprotein cholesterol (LDL-C) (P=0.005), and sCD40L (P<0.001). Hypertension (odds ratio OR]=2.598, P=0.028), LDL-C (OR=4.247, P=0.006), and serum sCD40L level (OR=1.079, P=0.009) were independent risk factors for the presence of carotid atherosclerotic plaque in patients with acute cerebral infarction. Compared with the stable plaque group, the unstable plaque group had a significantly higher proportion of patients with hypertension (P=0.031), as well as significantly higher levels of white blood cell count (P=0.002), LDL-C (P=0.003), and serum sCD40L level (P<0.001). In the unstable plaque group, hypertension (OR=2.918, P=0.033) and serum sCD40L level (OR=2.712, P<0.001) were independent risk factors for unstable carotid plaques.Conclusions In patients with acute cerebral infarction, the increase in serum sCD40L level might be associated with the development and progression of carotid atherosclerotic plaque and the instability of carotid plaque.