血清可溶性白细胞分化抗原配体与冠心病的相关性研究  

The association between sCD40L in serum and coronary heart disease

作　　者：杨耀[1] 孙翔[1] 朱志军[1] 张迎军[2] 

机构地区：[1]解放军第一一七医院心血管中心,浙江杭州310000 [2]内蒙古医科大学附属医院心内科,内蒙古呼和浩特010058

出　　处：《中国医药导报》2013年第18期10-13,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(编号81260284)

摘　　要：目的分析血清可溶性白细胞分化抗原配体(sCD40L)在各型冠心病患者及脂质斑块中的表达水平,探讨其浓度与冠心病的相关性,为今后将其作为冠心病患者危险性预测因子提供临床依据。方法选择到解放军第一一七医院心内科就诊的冠心病患者240例作为研究对象,并按照诊断结果分为稳定型心绞痛(SA)组、不稳定型心绞痛(UA)组、急性心肌梗死(AMI)组,同时,选取非冠心病患者200例作为对照组。采用双抗夹心ELISA法检测各组血清sCD40L浓度,分析冠心病不同类型组与对照组间血清sCD40L浓度差异。采用血管内超声检测冠心病患者血管内脂质含量,分析不同脂质含量患者的血清sCD40L浓度差异。结果 SA组、UA组、AMI组患者血清sCD40L浓度均高于对照组,差异有统计学意义(P<0.05),且SA组、UA组、AMI组间差异也均有统计学意义(P<0.05),AMI组血清sCD40L浓度最高,达到(7.03±1.22)mg/L,UA组次之[(3.59±1.09)mg/L]。不同脂质含量患者血清sCD40L浓度差异有高度统计学意义(F=7.985,P<0.01),各组间两两比较差异均有统计学意义(P<0.05);进一步采用Spearman法进行相关分析显示,血清sCD40L浓度与血管内脂质含量呈正相关关系(r=0.916,P<0.05),随着脂质含量的增加,血清sCD40L浓度升高。结论血清sCD40L含量与冠心病患病、不同类型冠心病的发生以及血管内脂质含量相关,可作为临床判断冠心病高危人群、预测心血管事件发生的重要指标。Objective To analyze the expression levels of serum sCD40L in lipid plaque and patients with different types of coronary heart disease（CAD）,then explore the relationship between its concentration and CAD,so as to pro vide clinical reference for prediction of the risk of CAD.Methods A total of 240 CAD patients treated in the Department of Cardiology in 117th Hospital of PLA were selected,and then divided into three groups,including SA group,UA group and AMI group.A total of 200 patients without CAD were selected as the control group.The ELISA method was used to detect the serum sCD40L concentration,then the differences of serum sCD40L concentrations among dif ferent types of CAD groups and the control group were compared.The intravascular ultrasound detection was per formed to detect the endovascular lipid,and the differences of serum sCD40L concentrations among patients with dif ferent lipid contents were compared.Results The sCD40L levels in the SA,UA and AMI groups were significantly higher than that in the control group（P 0.05）.There were significant differences in sCD40L levels among the SA,UA and AMI groups（P 0.05）.The sCD40L in the AMI group was the highest [（7.03 ±1.22） mg/L],followed by the UA group [（3.59±1.09） mg/L].There were significant difference in the sCD40L levels among patients with different lipid contents（F=7.985,P 0.01）,and there were signifcant difference between groups（P 0.05）.Spearman analysis indicated that there was positive association between sCD40L in serum and intravascular lipid（r=0.916,P 0.05）,the concentration of sCD40L in serum increased with the intravascular lipid content.Conclusion The sCD40L in serum associates with the incidence and types of CAD and intravascular lipid contents,which can be used as predictor for the high risk group and the incidence of CAD.

关 键 词：急性心肌梗死 可溶性白细胞分化抗原配体 冠心病 心绞痛 

分 类 号：R541.4[医药卫生—心血管疾病]