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目的:探讨急性冠状动脉(冠脉)综合征患者在不同糖耐量状态下,血清sCD40L水平与sICAM-1变化的相关性。方法:入选急性冠脉综合征患者148例,根据OGTT试验结果分为3组:糖耐量正常组、糖耐量减低组和糖尿病组,3组均于入院时即行酶联免疫吸附测定法(ELISA)检测血清sCD40L和sICAM-1的水平。结果:3组间sCD40L和sICAM-1水平差异有统计学意义:糖耐量减低组血清sCD40L和sICAM-1水平高于糖耐量正常组(P<0.05);糖尿病组明显高于糖耐量正常组(P<0.01);糖尿病组高于糖耐量减低组,但差异无统计学意义(P>0.05);sCD40L水平变化与sICAM-1呈显著正相关(r=0.644,P<0.01)。结论:当存在糖代谢紊乱时,血糖轻度受损即可过度激活血清CD40/CD40L通路,活化大量炎症及免疫因子,损伤血管内皮细胞,并且刺激血管内皮细胞表达sICAM-1增多,加重冠脉炎症反应,影响斑块内膜稳定性,促进急性冠脉综合征的发生、发展。
Objective: To investigate the correlation between serum sCD40L levels and sICAM-1 in patients with acute coronary syndrome (coronary syndrome) under different glucose tolerance. Methods: A total of 148 patients with acute coronary syndrome were enrolled and divided into 3 groups according to OGTT test: normal glucose tolerance group, impaired glucose tolerance group and diabetic group. All three groups were detected by enzyme linked immunosorbent assay (ELISA) Serum levels of sCD40L and sICAM-1 were measured. Results: The levels of sCD40L and sICAM-1 in the three groups were significantly different: the levels of sCD40L and sICAM-1 in the group with impaired glucose tolerance were higher than those in the normal glucose tolerance group (P <0.05); the levels in the diabetic group were significantly higher than those in the normal glucose tolerance group P <0.01). The level of sCD40L in sows with diabetes mellitus was significantly higher than that of sICAM-1 (r = 0.644, P <0.01), but the difference was not statistically significant (P> 0.05). Conclusion: When there is disorder of glucose metabolism, mild damage to blood glucose can activate serum CD40 / CD40L pathway, activate a large number of inflammatory and immune factors, damage vascular endothelial cells, and stimulate the expression of vascular endothelial cells increased sICAM-1, increased coronary Inflammatory reaction, affecting the stability of plaque intima and promoting the occurrence and development of acute coronary syndrome.