脑卒中高危人群颈动脉斑块与血清sCD40L之间的关系  

The relationship between carotid plaque of people at high risk of stroke and sCD40L

作　　者：秋大成 侯丽淳[1] 王辰[1] 毕胜[1] 杨慧[1] 王复新[1] 

机构地区：[1]佳木斯大学附属第一医院神经内科,黑龙江佳木斯154003

出　　处：《中风与神经疾病杂志》2015年第10期922-925,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的观察血清可溶性CD40配体(s CD40L)与高危人群颈动脉斑块性质之间的关系,为高危人群早期服用阿司匹林预防缺血性脑血管病提供依据。方法根据入选条件选取145例作为高危组,选取健康体检者40例作为对照组,据颈动脉超声检查结果将高危组分为无斑块组(Ⅰ)67例、稳定斑块组(Ⅱ)21例和不稳定斑块组(Ⅲ)57例3个亚组,采用酶联免疫吸附法(ELISA)测定所有研究对象血清s CD40L水平。结果高危组血清s CD40L水平明显高于对照组,差异有统计学意义P<0.05;高危组各亚组间血清s CD40L水平比较:Ⅰ组<Ⅱ组<Ⅲ组[(3.489±0.820)mg/ml<(3.600±0.697)mg/ml<(4.011±1.074)mg/ml],差异有统计学意义P<0.05;经Logistic回归分析结果显示:血清s CD40L(OR=1.788,P=0.037)是影响颈动脉斑块性质的危险因素。结论血清s CD40L是颈动脉粥样硬化斑块形成的危险因素;血清s CD40L可能影响颈动脉粥样硬化斑块的性质,促使其由稳定斑块向不稳定斑块的方向发展;对于脑卒中高危人群血清s CD40L水平较高者,应早期给予阿司匹林药物治疗,以此来预防缺血性脑血管病的发生、发展。Objective To observe the relationship between soluble CD40 ligand（ s CD40L） and carotid plaques of high-risk groups for cerebrovascular disease. To prove that the early dose of aspirin for high-risk groups can prevent the development of cerebrovascular ischemia. Methods According to the selected conditions,select 145 cases as a high-risk group,40 cases of physically healthy people as a control group,and divide the high-risk group patients into three subgroups by the ultrasound examination of carotid artery： no plaque group（ Ⅰ） 67 cases,stable plaque group（ Ⅱ） 21 cases and unstable plaque group（ Ⅲ） 57 cases. Determine the level of s CD40 L in all these groups by enzyme-linked immunosorbent（ ELISA）. Results The s CD40 L content of high-risk group was obviously higher than that of control group,the difference was statistically significant,P 〈0. 05. The difference of s CD40 L content between the subgroups of high-risk group： Ⅰ〈 Ⅱ〈 Ⅲ[（ 3. 489 ± 0. 820） mg / ml 〈（ 3. 600 ± 0. 697） mg / ml 〈（ 4. 011 ± 1. 074） mg / ml],the difference was statistically significant（ P〈 0. 05）. The Logistic regression analysis results showed that s CD40L（ OR = 1. 788,P = 1. 788） is was one factor that affect the nature of the carotid plaques. Conclusion The s CD40 L is a risk factor leading to the formation of carotid plaque. The s CD40 L may affect the nature of the carotid plaque promoting the progress of stable plaques to unstable plaques. The people at high risk for stroke with high level of s CD40 L should be given aspirin therapy early in order to prevent the occurrence and development of ischemic cerebrovascular disease.

关 键 词：SCD40L 动脉粥样硬化 斑块不稳定性 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]