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目的:探讨可溶性白细胞分化可溶性抗原40配体(sCD40L)和超敏C反应蛋白(hs-CRP)在急性冠脉综合征(ACS)患者发病及预后中的临床意义及机制。方法:根据急性冠脉综合征诊断标准选择86例患者,分为两组:正常对照组(NCHD)17例,ACS组69例,其中不稳定心绞痛(UA)58例,急性心肌梗死(AMI)11例,入院当天采用ELISA测定血清sCD40L浓度和hs-CRP水平。随诊2个月,观察急性心血管事件发生率。结果:ACS组明显高于对照组(P<0.01);AMI组略高于UA组但无统计学意义(P>0.05);sCD40L和或hs-CRP升高组心血管事件较正常组增多。结论:急性冠脉综合征患者早期外周血清sCD40L和hs-CRP水平明显升高,提示CD40/CD40L系统与ACS的发生有关,并与炎症因子C反应蛋白协同,对动脉粥样硬化斑块不稳定性起着重要作用。
Objective: To investigate the clinical significance and mechanism of sCD40L and hs-CRP in the pathogenesis and prognosis of patients with acute coronary syndrome (ACS). Methods: According to the diagnostic criteria of acute coronary syndrome, 86 patients were divided into two groups: 17 in normal control group (NCHD), 69 in ACS group, including 58 cases of unstable angina pectoris (UA), acute myocardial infarction (AMI) In the 11 cases, serum sCD40L concentration and hs-CRP level were measured by ELISA on the day of admission. Follow-up 2 months, observed the incidence of acute cardiovascular events. Results: The ACS group was significantly higher than that of the control group (P <0.01). The AMI group was slightly higher than the UA group (P> 0.05). The cardiovascular events of sCD40L and / or hs-CRP increased group compared with the normal group. CONCLUSIONS: The levels of sCD40L and hs-CRP in peripheral blood of patients with acute coronary syndrome are significantly increased, suggesting that CD40 / CD40L is associated with the occurrence of ACS and is synergistic with inflammatory cytokine C-reactive protein and is unstable to atherosclerotic plaque Sex plays an important role.