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目的:研究冠心病患者血清sCD40L和hs-CRP临床特点及其关系,探讨其在冠心病预测和治疗中的意义。方法:采用夹心法酶联免疫吸附测定分析法及微粒子增强透射免疫分析法分别对对照组15例、稳定型心绞痛(SAP)组27例、不稳定型心绞痛(UAP)组35例及急性心肌梗死(AMI)组14例受试者血清sCD40L和hs-CRP水平进行检测,并观察其与冠脉狭窄程度的相关性。结果:1)、血清hs-CRP水平:SAP组、UAP组、AMI组呈依次递增(AMI组比UAP组、UAP组比SAP组P<0.05,AMI组、UAP组比对照组(P<0.01);SAP组与对照组血清hs-CRP水平相似;2)、血清sCD40L水平:AMI组及UAP组血清sCD40L水平高于SAP组和对照组(P<0.01),AMI组与UAP组之间、SAP与对照组间没有统计学差异;3)、相关分析显示血清sCD40L水平与hs-CRP水平显著相关(r=0.787,P<0.0001),两者均与冠脉狭窄程度无相关性。结论:血清hs-CRP、sCD40L水平升高与冠心病临床表现类型和病情是否稳定有关,与冠状动脉狭窄程度无关,此两项指标能够用于冠心病病情不稳定性的判断和预测。
Objective: To study the clinical features and relationship of serum sCD40L and hs-CRP in patients with coronary heart disease (CHD) and to explore its significance in the prediction and treatment of coronary heart disease. Methods: Fifteen patients in the control group, 27 patients in stable angina pectoris group (SAP), 35 patients in unstable angina pectoris group (UAP) and 30 patients in acute myocardial infarction group were treated with sandwich enzyme-linked immunosorbent assay and microparticle enhanced transmission immunoassay. (AMI) group of 14 subjects serum sCD40L and hs-CRP levels were measured and observed the degree of coronary stenosis correlation. Serum hs-CRP levels were increased in SAP group, UAP group and AMI group (P <0.01 in AMI group, P <0.05 in UAP group, P <0.01 in AMI group and UAP group) ). Serum levels of ss-CRP in SAP group and control group were similar; 2) Serum levels of sCD40L: Serum levels of sCD40L in AMI group and UAP group were higher than those in SAP group and control group (P <0.01) There was no significant difference between SAP and control group; 3) The correlation analysis showed that serum sCD40L level was significantly correlated with hs-CRP level (r = 0.787, P <0.0001), both of which had no correlation with coronary stenosis. Conclusion: The serum levels of hs-CRP and sCD40L are correlated with the clinical manifestations and severity of coronary heart disease, but not with the degree of coronary artery stenosis. These two indexes can be used to judge and predict the instability of coronary heart disease.