CD40L高表达在急性冠脉综合症病人中的临床意义

摘要

Objective To investigate clinical implications of expression of CD40L in monocytes and changes in serum soluble CD40L in patients with acute coronary syndromes (ACS). Methods Sixteen control and 56 patients, including 24 with stable angina (SA), 20 with unstable angina (UA) and 12 with acute myocardial infarction (AMI) enrolled in this study. Expression of CD40L in monocytes was analyzed by flow cytometry and sCD40L levels were measured by ELISA. Results Expression of CD40L in monocytes and serum levels of sCD40L in UA and AMI patients were higher than in SA patients and controls. In patients with AMI, sCD40L levels showed no significant increase when compared to patients with UA, while AMI patients had a peak level of sCD40L at 24 hours after AMI. PTCA induced a marked rise in sCD40L levels in all patients, while CD40L expression in monocytes showed no difference between patients with PTCA, before and after. Conclusion Enhanced level of serum sCD40L may be a reliable prognostic indicator for ACS and may represent a marker of coronary disease activity.%目的探讨急性冠脉综合症(ACS)病人外周血单核细胞表达CD40L及血清可溶性CD40L(sCD40L) 变化的临床意义.方法应用流式细胞术和ELISA分别对正常对照组16例、稳定心绞痛24例、不稳定心绞痛20例、急性心肌梗死12例患者血单核细胞表达CD40L及血清可溶性sCD40L水平进行检测.结果 UA组及AMI组血单核细胞表达CD40L及血清sCD40L水平明显较SA和对照组高(P<0.01) .AMI患者血清sCD40L水平与UA组无差异(P>0.05),但AMI发病后24小时sCD40L有一峰值.PTCA后血清sCD40L明显高于PTCA前(P<0.01),但血单核细胞表达CD40L无差异(P >0.05).结论血清可溶性CD40L升高是判断ACS的可靠血清学指标,且可能是冠脉病变的活动性标志物.