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目的探讨CD40L和基质金属蛋白酶(MMP)在冠脉斑块形成中的作用机制。方法对59例冠状动脉造影证实,有冠状动脉狭窄的急性冠脉综合症患者(男31例,女28例,平均年龄60·3岁),分为不稳定型心绞痛组(n=32)、急性心肌梗死组(n=27),同时设正常对照组(体检健康者,n=30)。采用ELISA法检测血清CD40L、C反应性蛋白(CRP)、MMP-2和MMP-9的水平。结果与正常对照组比较,血清CD40L、CRP、MMP-2和MMP-9的水平,随病情的加重而升高且差异显著(P<0·01),多支病变者的水平高于单支病变者。血清MMP-2与MMP-9的水平、CD40L与MMP-9的水平均呈正相关(r值分别为0·71和0·78)。结论血清MMP-2和MMP-9水平的增高与冠脉斑块的形成有一定的联系。CD40L可能是通过MMP-s引起冠脉损伤,从而导致斑块形成和冠心病的发生发展。
Objective To investigate the mechanism of CD40L and matrix metalloproteinases (MMPs) in the formation of coronary plaque. Methods Fifty-nine patients with acute coronary syndrome (31 males and 28 females, average age 60.3 years) with coronary artery stenosis were divided into unstable angina group (n = 32), coronary angiography Acute myocardial infarction group (n = 27), while the normal control group (healthy subjects, n = 30). Serum levels of CD40L, C-reactive protein (CRP), MMP-2 and MMP-9 were detected by ELISA. Results Compared with the normal control group, the levels of serum CD40L, CRP, MMP-2 and MMP-9 increased with the severity of the disease and the difference was significant (P <0.01). The levels of multi-vessel disease were significantly higher than those of the single vessel Lesion. Serum MMP-2 and MMP-9 levels, CD40L and MMP-9 levels were positively correlated (r values were 0.71 and 0.78, respectively). Conclusion The increase of serum MMP-2 and MMP-9 levels is related to the formation of coronary plaque. CD40L may be caused by MMP-s coronary artery injury, leading to plaque formation and the development of coronary heart disease.