外周血sCD40L、sLOX-1在冠状动脉慢血流型心绞痛患者的机制  

Changes and mechanisms of peripheral sCD40L and sLOX-1 in patients with coronary slow flow angina

作　　者：李永星[1] 王琰[1] 吴清华 赵亚娟 胡亚民[1] Li Yongxing;Wang Yan;Wu Qinghua;Zhao Yajuan;Hu Yamin(Department of Cardiology,Central Hospital of Cangzhou City,Hebei Province,Cangzhou 061001,China)

机构地区：[1]沧州市中心医院心内科,沧州061001

出　　处：《中国循证心血管医学杂志》2020年第4期476-479,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨外周血可溶性白细胞分化抗原40配体(sCD40L)、可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)在冠状动脉(冠脉)慢血流型心绞痛患者的变化与可能机制。方法选择2016年1月~2019年7月于沧州市中心医院心内科收治的80例冠脉慢血流型心绞痛患者作为观察组,另选择同期进行冠脉造影正常患者60例为对照组,比较两组患者的临床资料、心血管危险因素、外周血sCD40L、sLOX-1、平均矫正心肌梗死溶栓试验(TIMI)血流帧数等。根据心绞痛疗效判断分为2组:56例预后良好组(心绞痛发作次数减少>50%)和24例预后不良组(心绞痛发作次数无改善或增加),分析外周血sCD40L、sLOX-1在冠脉慢血流型心绞痛的作用机制及与预后的关系。结果两组性别、年龄、体质指数(BMI)、高血压、高血脂、吸烟、空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胱抑素C(Cys C)和髓过氧化物酶(MPO)比较,差异均无统计学意义(P>0.05);观察组外周血sCD40L、sLOX-1、平均矫正TIMI血流帧数均明显高于对照组(P均<0.05);预后良好组外周血sCD40L、sLOX-1、平均矫正TIMI血流帧数均明显低于预后不良组(P均<0.05);经Pearson相关性分析显示,外周血sCD40L、sLOX-1和平均矫正TIMI血流帧数均呈正相关(P<0.05);经Logistic回归分析显示,外周血sCD40L、sLOX-1均是冠脉慢血流型心绞痛发生的独立危险因素(P<0.05)。结论外周血sCD40L、sLOX-1在冠脉慢血流型心绞痛患者表达明显升高,可能通过加重血管炎症、内皮损伤等途径参与疾病的发生和发展,是预后不良的独立危险因素,动态检测外周血sCD40L、sLOX-1的变化可辅助判断病情与预后。Objective To investigate the changes and possible mechanisms of peripheral soluble CD40 ligand(sCD40L)and soluble lectin like ox-LDL receptor-1(sLOX-1)in patients with coronary slow flow angina.Methods The patients(n=80)were chosen into observation group and patients with normal coronary angiography results(n=60)were chosen into control group from Department of Cardiology in Central Hospital of Cangzhou City from Jan.2016 to July 2019.The clinical materials,cardiovascular risk factors,peripheral sCD40L and sLOX-1 changes and mean corrected thrombolysis in myocardial infarction frame counts(CTFC)were compared between 2 groups.The patients were divided again,according to efficacy judgment of angina pectoris(AP),into good prognosis group(n=56,AP attack times>50%)and poor prognosis group(n=24,no relief or more in AP attack times).The mechanism of peripheral sCD40L and sLOX-1 effects on coronary slow flow angina the relationship between them and prognosis.Results The difference in sex,age,body mass index(BMI),hypertension,high blood fat,smoking,fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C),cystatin C(Cys C)and myeloperoxidas(MPO)had no statistical significance between observation group and control group(P>0.05).The levels of peripheral sCD40L and sLOX-1 and CTFC were significantly higher in observation group than those in control group(all P<0.05).The levels of peripheral sCD40L and sLOX-1 and CTFC were significantly lower in good prognosis group than those in poor prognosis group(all P<0.05).The results of Pearson correlation analysis showed that levels of peripheral sCD40L and sLOX-1 were positively correlated to CTFC(P<0.05).The results of Logistic regression analysis showed that levels of peripheral sCD40L and sLOX-1 were independent risk factors of coronary slow flow angina(P<0.05).Conclusion The levels of peripheral sCD40L and sLOX-1 increase significantly in patients with coronary slow flow angina,which ma

关 键 词：冠状动脉慢血流型心绞痛 可溶性白细胞分化抗原40配体 可溶性凝集素样氧化型低密度脂蛋白受体-1 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]