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目的观察冠状动脉慢血流(SCF)患者与血流正常者血清可溶性白细胞分化抗原40配体(s CD40L)及相关黏附分子的水平,探讨SCF可能的发生机制。方法 ELISA方法检测并比较60例经冠状动脉造影证实为SCF患者及40例冠状动脉造影正常者血清中s CD40L以及细胞间黏附因子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)和E-选择素等黏附分子水平,并分析SCF与这些黏附分子的相关性。结果冠状动脉造影结果显示,SCF组患者冠状动脉各主要分支的血流帧数均明显高于对照组(P均<0.01)。SCF患者血清s CD40L、ICAM-1、VCAM-1和E-选择素的水平均明显高于正常组,差异有统计学意义(P均<0.01)。相关分析显示SCF患者冠状动脉血流帧数与血清中s CD40L(r=0.499,P<0.01)、VCAM-1(r=0.562,P<0.01)、ICAM-1(r=0.512,P<0.01)和E-选择素(r=0.550,P<0.01)水平呈正相关;SCF患者血清中s CD40L的水平与VCAM-1(r=0.701,P<0.01)、ICAM-1(r=0.694,P<0.01)和E-选择素(r=0.688,P<0.01)水平呈正相关。结论 s CD40L可能通过促进黏附分子的表达介导SCF的发生、发展。
Objective To observe the levels of serum sCD40L and related adhesion molecules in patients with chronic coronary artery disease (SCF) and normal blood flow and to explore the possible mechanism of SCF. Methods The levels of s-CD40L, ICAM-1 and VCAM-1 in serum of 60 patients with SCF confirmed by coronary angiography and 40 patients with coronary angiography were detected by ELISA. 1) and E-selectin, and analyzed the correlation between SCF and these adhesion molecules. Results Coronary angiography showed that the number of blood flow frames in all major coronary arteries of SCF patients was significantly higher than that of the control group (all P <0.01). The levels of serum CD40L, ICAM-1, VCAM-1 and E-selectin in SCF patients were significantly higher than those in normal controls (P <0.01). Correlation analysis showed that the number of coronary blood flow in SCF patients was significantly correlated with the levels of sCD40L (r = 0.499, P <0.01), VCAM-1 ) And E-selectin (r = 0.550, P <0.01). The level of s-CD40L in serum of SCF patients was significantly higher than that of VCAM-1 (r = 0.701, <0.01) and E-selectin (r = 0.688, P <0.01). Conclusion CD40L may mediate the development of SCF by promoting the expression of adhesion molecules.