戒烟对急性冠脉综合征患者血清sCD40L和sFasL的水平影响  

Effects of smoking-cessation on the levels of serum sCD40L and sFasL in patients with acute coronary syndrome

作　　者：王小庆[1] 孙艳 王毅[1] 钟岸[1] 钟新波[1] 彭长农[1] 廖志勇[1] 

机构地区：[1]深圳市孙逸仙心血管医院心内科,广东深圳518000 [2]深圳市西丽人民医院内分泌科,广东深圳518000

出　　处：《热带医学杂志》2013年第9期1100-1102,1105,共4页Journal of Tropical Medicine

基　　金：深圳市科技计划项目(201002121)

摘　　要：目的了解急性冠脉综合征(ACS)患者戒烟后反应冠脉斑块易损性的血清指标sCD40L和sFasL水平的变化。方法将50例有吸烟史并经冠脉造影确诊为ACS的患者分为吸烟组和戒烟组,每组25例,另选取40例经冠脉造影确诊为稳定型冠心病(SA)患者,根据是否吸烟分为吸烟对照组和不吸烟组。分别在戒烟前、戒烟6个月及1年后检测血清sCD40L和sFasL水平,进行组间及组内自身对照比较,同时观察患者主要心血管事件发生率的差异。结果 ACS组血清sCD40L和sFasL水平较SA组升高明显,差异有统计学意义。戒烟6个月后血清sCD40L和sFasL水平较戒烟前明显降低[分别为(1 525.8±155.3)ng/L vs(232.6±28.3)ng/L、(906.5±25.2)pg/L vs(120.5±18.2)pg/L,P<0.01],戒烟1年时血清sCD40L和sFasL水平与戒烟前比较仍保持持续低水平,与戒烟6个月时比较虽有轻度下降,但差异无统计学意义。与吸烟组比较,戒烟6个月后血清sCD40L和sFasL水平明显减低[分别为(441.7±27.1)ng/L vs(232.6±28.3)ng/L、(329.2±29.7)pg/L vs(120.5±18.2)pg/L,P<0.01]。随访期间戒烟组主要心血管不良事件发生率与吸烟组相比有下降,但差异无统计学意义。结论戒烟能在较短时间内减低血清sCD40L和sFASL水平,减轻冠脉斑块部位炎症反应及细胞凋亡,降低冠脉斑块的易损性,减少冠脉事件的发生率。Objective This study aimed to evaluate the effects of smoking cessation on the levels of serum sCD40L and sFasL in patients with acute coronary syndrome. Methods 50 patients with acute coronary syndrome and a history of smoking diagnosed by coronary angiography were randomized and equally divided into 2 groups： smoking group and smoking-cessation group. Another 40 cases with stable coronary artery disease diagnosed by coronary angiography were divided into smoking group and non-smoking group. The levels of serum sCD40L and sFasL were measured. Major cardiovascular events were monitored before smoking cessation and at 6 to 12 months after smoking cessation. Results The levels of sCD40L and sFasL were significantly higher in patients with acute coronary syndrome than the patients with stable coronary artery disease. Six months after smoking cessation, the level of sCD40L and sFasL was changed from （1 525.8±155.3）ng/L to （232.6±28.3）ng/L and from （906.5±25.2）pg/L to （ 120.5±18.2）pg/L, respectively （P〈0.01）. The levels of sCD40L and sFasL were maintained at a low level at 1 year after smoking cessation, but the level was not significantly lower than the level at 6 months after smoking cessation Compared with the smoking group, the levels of sCD40L （441.7±27.1）ng/L vs （232.6±28.3）ng/L and sFasL （329.2±29.7）pg/L vs （120.5±18.2）pg/L were significantly reduced at 6 months after smoking cessation （P〈0.01）. Conclusion Smoking cessation can reduce the levels of sCD40L and sFasL, and also inflammation and apoptosis in coronary plaque.

关 键 词：急性冠脉综合征 戒烟 SCD40L SFASL 

分 类 号：R541.4[医药卫生—心血管疾病]