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目的观察不同类型的冠心病患者的血浆可溶性CD40配体(sCD40L)的水平变化及其与白介素6(IL-6)之间的相互关系,探讨急性冠脉综合征(ACS)的发病机制和临床识别和预测的炎症因子指标。方法采用酶联免疫吸附法分别测定对照组28例、和稳定性心绞痛(SCHD)28例和急性冠脉综合征32例外周血浆的sCD40L、IL-6和高敏C反应蛋白(Hs-CRP)的水平。结果在ACS组sCD40L(2.12±1.45)ng/mL水平显著高于对照组sCD40L(0.52±0.44)ng/mL和SCHD组(0.68±0.47)ng/mL,P<0.01有显著统计学差异;sCD40L水平在SCHD组稍高于对照组,P>0.05差异无统计学意义。在ACS组中sCD40L水平与IL-6水平呈显著正相关(r=0.872,P<0.01)。结论本研究结果表明急性冠脉综合征患者早期外周血sCD40L水平明显升高,提示可能与急性冠脉综合征发生有关,是动脉粥样硬化斑块不稳定的标志;CD40与CD40L相互作用在动脉粥样硬化斑块不稳定发生起着重要作用,可能与其通过上调IL-6表达有关而导致斑块破裂、血栓形成。
Objective To observe the changes of serum soluble CD40 ligand (sCD40L) and interleukin-6 (IL-6) in different types of patients with coronary heart disease (CHD) and to explore the pathogenesis of acute coronary syndrome (ACS) Identify and predict inflammatory markers. Methods Serum levels of sCD40L, IL-6 and high-sensitivity C-reactive protein (Hs-CRP) were measured in 28 patients in the control group and 28 patients with stable angina pectoris (SCHD) and 32 patients with acute coronary syndrome by enzyme-linked immunosorbent assay Level. Results The level of sCD40L (2.12 ± 1.45) ng / mL in ACS group was significantly higher than that of sCD40L (0.52 ± 0.44) ng / mL and SCHD group (0.68 ± 0.47) ng / mL in SCH group The level of SCHD slightly higher than the control group, P> 0.05 difference was not statistically significant. There was a significant positive correlation between sCD40L level and IL-6 level in ACS group (r = 0.872, P <0.01). Conclusions The results of this study indicate that sCD40L levels in peripheral blood of patients with acute coronary syndrome are significantly increased, which may be related to the occurrence of acute coronary syndrome. It is a marker of atherosclerotic plaque instability. CD40 interacts with CD40L in the arteries The occurrence of atherosclerotic plaque instability plays an important role, which may be related to the plaque rupture and thrombosis by up-regulating the expression of IL-6.