CAJ | 학술논문

目的探讨血清可溶性CD40配体(soluble CD40 ligand,sCD40L)与颈动脉斑块稳定性的相关性,及对缺血性脑卒中发生和复发的预测作用.方法对本院112例急性脑梗死患者及40例无卒中病史体检者采用ELISA法测定血清sCD40L水平,并对急性脑梗死患者复发情况进行随访.结果脑梗死组血清sCD40L水平[(3.82±1.03) ng/ml]高于对照组[(2.69±0.48) ng/ml,t=6.654,P＜0.01].脑梗死组中不稳定斑块组血清sCD40L水平[(4.62±1.23) ng/ml]高于稳定斑块组[(4.10±0.87) ng/ml)；前两组均高于无斑块组[(3.19 ±0.57) ng/ml,F=13.139,P＜0.01].脑梗死患者各组危险因素Logistic回归分析示,sCD40L、男性构成比、高血压为不稳定斑块的危险因素(β=5.218,3.482,2.321,P＜0.01或P＜0.05；OR=184.525,32.536,10.182),sCD40L水平对不稳定斑块影响显著(P＜0.01,OR=184.525,95％ CI:5.741-5931.286).脑梗死组一年内复发的患者其初发卒中时血清sCD40L水平[(5.87±0.67) ng/ml]高于未复发者[(3.67±0.87)ng/ml,t=3.667,P＜0.01].结论 sCD40L、男性构成比、高血压为不稳定斑块的危险因素,血清sCD40L可能参与颈动脉粥样硬化斑块由稳定向不稳定性的方向发展,促进斑块破裂,引起缺血性脑卒中的发生和复发.测定血清sCD40L水平对缺血性脑卒中不良事件有一定的预测作用.
목적 탐토혈청가용성CD40배체(soluble CD40 ligand,sCD40L)여경동맥반괴은정성적상관성,급대결혈성뇌졸중발생화복발적예측작용.방법 대본원112례급성뇌경사환자급40례무졸중병사체검자채용ELISA법측정혈청sCD40L수평,병대급성뇌경사환자복발정황진행수방.결과 뇌경사조혈청sCD40L수평[(3.82±1.03) ng/ml]고우대조조[(2.69±0.48) ng/ml,t=6.654,P＜0.01].뇌경사조중불은정반괴조혈청sCD40L수평[(4.62±1.23) ng/ml]고우은정반괴조[(4.10±0.87) ng/ml)；전량조균고우무반괴조[(3.19 ±0.57) ng/ml,F=13.139,P＜0.01].뇌경사환자각조위험인소Logistic회귀분석시,sCD40L、남성구성비、고혈압위불은정반괴적위험인소(β=5.218,3.482,2.321,P＜0.01혹P＜0.05；OR=184.525,32.536,10.182),sCD40L수평대불은정반괴영향현저(P＜0.01,OR=184.525,95％ CI:5.741-5931.286).뇌경사조일년내복발적환자기초발졸중시혈청sCD40L수평[(5.87±0.67) ng/ml]고우미복발자[(3.67±0.87)ng/ml,t=3.667,P＜0.01].결론 sCD40L、남성구성비、고혈압위불은정반괴적위험인소,혈청sCD40L가능삼여경동맥죽양경화반괴유은정향불은정성적방향발전,촉진반괴파렬,인기결혈성뇌졸중적발생화복발.측정혈청sCD40L수평대결혈성뇌졸중불량사건유일정적예측작용.