血清sCD40L检测在评价急性冠脉综合征发病风险中的应用  

Serum sCD40L detection for risk evaluation of acute coronary syndromes

作　　者：徐邦牢[1] 贝春花[1] 王蓉[1] 雷秀霞[1] 

机构地区：[1]广州市第一人民医院检验科,广东广州510180

出　　处：《南方医科大学学报》2006年第11期1656-1657,共2页Journal of Southern Medical University

基　　金：广州市科技攻关项目(2004Z3-E0441)

摘　　要：目的探讨分析sCD40L检测在评价急性冠脉综合征(ACS)发病风险中的意义。方法选取经临床确诊的ACS患者200例,随访全部病例为时6个月,以发生死亡及非致命性心肌梗死为试验观察终点。在发病72h内空腹状态下采取病例前臂静脉血并分离血清,用ELISA方法测定血清sCD40L及C-反应蛋白(CRP)水平;用微粒子化学发光方法测定cTnI水平。结果200例观察对象中108例血清sCD40L水平高于5.0μg/L。随访观察6个月后,发现高水平的sCD40L、CRP及cTnI与ACS患者发生死亡及非致命性心肌梗死的风险显著相关(P=0.001,P=0.02及P=0.001)。结论血清sCD40L、CRP及cTnI水平升高可用于独立预测ACS患者高风险心血管病事件。三者联合检测可明显提高诊断和预测ACS的灵敏度,并有望取代现有的心肌酶检测而成为新一代心血管病诊断和风险预测的临床实验室项目。Objective To investigate the value of serum soluble CD40 ligand （sCD40L） detection in risk evaluation of acute coronary syndromes （ACS）, Methods This study involved 200 patients with established diagnosis of ACS, with death or nonfatal myocardial infarction as the end point of observation during the 6-month-long follow-up. Blood samples were obtained from the patients within the initial 72 h of ACS onset, and the levels of sCD40L and C-reactive protein （CRP） were determined with enzyme-linked immunosorbent assay （ELISA）. Cardiac troponin I （cTnI） measurement was performed using chemiluminescent immunoassay, Results Of the 200 patients, 108 had serum sCD40L levels higher than 5.0 μg/L, and the levels of sCD40L, CRP and cTnI were found to significantly correlate with ACS. Conclusion Independent detection of serum sCD40L, CRP and cTnI can help predict the risks of ACS, and their combined measurement may increase the sensitivity of the risk prediction and provide new cardiac makers to replace the cardiac enzymes for laboratory diagnosis and risk evaluation of cardiovascular events.

关 键 词：冠脉综合征 SCD40L C-反应蛋白 CTNI 风险因子 

分 类 号：R541.4[医药卫生—心血管疾病]