CD40配体预测急性冠状动脉综合征的临床价值  

The clinical significance of CD40L level in the diagnosis of ACS

作　　者：赵进军[1] 赵波[1] 张颖[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院心内科,哈尔滨150001

出　　处：《中国实用内科杂志》2008年第1期49-51,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的观察不同类型冠心病患者可溶性CD40配体(sCD40L)的变化,探讨其在急性冠状动脉综合征(ACS)诊断中的价值。方法选择2006年1月至6月在哈尔滨医科大学第一临床医学院心内科住院的冠心病患者66例和健康对照者20名。冠心病组包括ACS患者和稳定型心绞痛(SA)患者两组,采用酶联免疫吸附试验(ELISA)方法统一测定入选人群血清中sCD40L的质量浓度,采用t检验及评价不同试验方法临床准确性的受试者工作特征曲线(ROCcurve)等统计学方法进行分析。结果ACS患者的sCD40L[(2.39±0.37)μg/L]显著高于对照组[(1.76±0.17)μg/L,P<0.01]和SA组[(1.89±0.16)μg/L,P<0.01]。SA患者与对照组比较差异无显著性意义,P>0.05。ROC曲线显示,将sCD40L质量浓度2.01μg/L作为临界值诊断ACS的灵敏度为91%,特异度为80%,曲线下面积(AUC)为0.907。结论sCD40L质量浓度大于2.01μg/L对于ACS的诊断有重要临床意义。Objective To observe the difference of sCD40L level in different subtypes of coronary heart disease, and to explore the clinical value of CD40 ligand in identification for the acute coronary syndrome （ACS）. Methods The patients with coronary heart disease （ CHD ） and the heathy controls in the First Affiliated Hospital of Harbin Medical University from Jan,2006 to June,2006 were enrolled in the study. CHD group included ACS and stable angina patients. Enzymelinked immunosorbent assay was used to measure the serum sCD40L level in three groups;t-test and receiver operateing characteristic curve were used to analyze the results. Results sCD40L level was significantly higher in patients with ACS [ （ 2. 39 ± 0. 37 ） μg/L ] than stable angina patients [ （ 1.89 ± 0. 16 ） μg/L, P 〈 0. 01 ] and control group [ （ 1.76 ± 0. 17 ） μg/L,P 〈0.01 ]. Comparison of stable angina patients with control group had no distinct meaning,P 〉 0. 05. The ROC curve demonstrated that using the concentration of sCD40L 2. 01 μg/L as the boundary to diagnose ACS, sensitivity of this marker was 0. 91 and specificity was 0. 80 respectively, and area under the curve （ AUC ） was 0. 907. Conclusion sCD40L level which is more than 2. 01 μg/L has important significance for the diagnosis of ACS.

关 键 词：急性冠状动脉综合征 可溶性CD40配体 易损斑块 

分 类 号：R5[医药卫生—内科学]