可溶性CD40配体和炎症因子水平表达在颈动脉粥样硬化患者的应用  

Clinical significance of expression of soluble CD40 ligand and inflammatory cytokines in carotid atherosclerosis

作　　者：刘首明 江小萍 沈祖泓 刘冰冰 朱少琴 柳健 LIU Shouming;JIANG Xiaoping;SHEN Zuhong;LIU Bingbing;ZHU Shaoqin;LIU Jian(Qingyuan Hospital of Traditional Chinese Medicine,Qingyuan 511500,China;不详)

机构地区：[1]清远市中医院,广东清远511500

出　　处：《现代医院》2021年第5期803-806,共4页Modern Hospitals

基　　金：广东省中医药局建设中医药强省立项资助科研课题资助(20121098);清远市产业技术与研究开发专项资金资助(2014A006)。

摘　　要：目的探讨血清可溶性CD40配体(sCD40L)和炎症因子IL-1、IL-6、IL-10、肿瘤坏死因子-α(TNF-α)、超敏CRP(hsCRP)表达水平与颈动脉内膜中层厚度(CIMT)及斑块与动脉粥样硬化患者的关系。方法收集111例CIMT≥0.9 mm和(或)有颈动脉粥样硬化斑块患者,根据用药情况分为氟伐他汀组37例、三七总皂苷组36例、中西医结合组38例。治疗周期均为12周。采用双抗体夹心ELISA法测定sCD40L、IL-1、IL-6、IL-10、TNF-α;采用免疫比浊法测定hsCRP及彩色超声仪检测CIMT及斑块。观察3组患者服药前后其指标的变化。结果用药后,3组患者sCD40L、IL-1、IL-6、TNF-α、hsCRP、CIMT及斑块积分明显低于用药前,IL-10明显高于用药前,差异有统计学意义(P<0.05);用药后,中西医结合组患者与氟伐他汀组、三七总皂苷组比较,sCD40L、IL-1、IL-6、TNF-α、hsCRP、CIMT及斑块积分显著降低,IL-10明显增高,差异有统计学意义(P<0.05)。结论血清sCD40L和IL-1、IL-6、IL-10、TNF-α、hsCRP水平的表达与颈动脉内膜中层厚度(CIMT)及斑块的变化在颈动脉粥样硬化患者治疗前后有着重要的临床价值。Objective To investigate the relationships of carotid atherosclerosis with serum soluble CD40 ligand(sCD40 L) and inflammatory factors IL-1, IL-6, IL-10, tumor necrosis factor-α(TNF-α), high sensitivity C reactionprotein(hsCRP) expression levels and carotid intima-media thickness(CIMT) and plaque.Methods A total of 111 cases with CIMT ≥0.9 mm and/or carotid atherosclerotic plaques were collected, and divided into fluvastatin group(n=37), panax notoginseng total saponin group(n=36) and integrated traditional Chinese and western medicine group(n=38) according to drug use. The treatment period was 12 weeks. SCD40 L, IL-1, IL-6, IL-10 and TNF-α were determined by double antibody sandwich ELISA. Immune turbidimetric assay was used to detect hsCRP and color ultrasonography was used to detect CIMT and plaque. The changes of indexes across the 3 groups were observed and compared before and after the drug administration.Results After the drug administration, the scores of SCD40 L, IL-1, IL-6, TNF-α, hsCRP, CIMT and plaques in the 3 groups were significantly lower than that before medication, and IL-10 was significantly higher, with the statistically significant difference(P<0.05). After the drug administration, the scores of sCD40 L, IL-1, IL-6, TNF-α, hsCRP, CIMT and plaque were significantly decreased, as compared with the fluvastatin group and panax notoginseng saponins group by Chinese and western medicine group;IL-10 was significantly increased(P<0.05).Conclusion The horizontal expression of serum sCD40 L and IL-1, IL-6, IL-10, TNF-α, hsCRP and the changes of carotid intima-media thickness(CIMT) and plaque have important clinical value in patients with carotid atherosclerosis before and after treatment.

关 键 词：可溶性CD40配体 炎症因子 肿瘤坏死因子Α 动脉粥样硬化 

分 类 号：R543.5[医药卫生—心血管疾病] R446.1[医药卫生—内科学]