CAJ | 학술논문

目的：观察早发冠心病患者的血小板CD40配体（ CD40 L）表达变化并探讨其意义。方法因胸闷、胸痛而接受冠状动脉造影的患者200例，造影显示冠状动脉狭窄140例（早发冠心病组）、冠状动脉无狭窄60例（对照组）。采用流式细胞技术测定血小板CD40 L平均荧光强度， ELISA法检测血浆组织因子（ TF）及组织因子途径抑制物（TFPI）。结果早发冠心病组血小板CD40L荧光强度为（19．3±6．1）a．u，血浆TF为（70．0±9．5）ng／L、TFPI为（68．0±9．4）μg／L、TF／TFPI为1．3±0．1，对照组分别为（8．8±2．4）a．u、（55．3±7．5）ng／L、（59．3±7．7）μg／L、0．9±0．1，两组相比，P＜0．05或P＜0．01；血小板CD40 L荧光强度与早发冠心病患者血浆TF、TFPI、TF／TFPI均呈正相关（r分别为0．43、0．32、0．30，P均＜0．01）；血小板CD40L荧光强度与早发冠心病患者血浆TF水平呈独立正相关（B＝0．4，P＜0．01）、与早发冠心病发病呈独立正相关（B＝0．8，P＜0．01）。结论早发冠心病患者血小板CD40 L表达增强，高CD40 L水平可能通过促进TF的表达而促进早发冠心病的发生发展。
목적：관찰조발관심병환자적혈소판CD40배체（ CD40 L）표체변화병탐토기의의。방법인흉민、흉통이접수관상동맥조영적환자200례，조영현시관상동맥협착140례（조발관심병조）、관상동맥무협착60례（대조조）。채용류식세포기술측정혈소판CD40 L평균형광강도， ELISA법검측혈장조직인자（ TF）급조직인자도경억제물（TFPI）。결과조발관심병조혈소판CD40L형광강도위（19．3±6．1）a．u，혈장TF위（70．0±9．5）ng／L、TFPI위（68．0±9．4）μg／L、TF／TFPI위1．3±0．1，대조조분별위（8．8±2．4）a．u、（55．3±7．5）ng／L、（59．3±7．7）μg／L、0．9±0．1，량조상비，P＜0．05혹P＜0．01；혈소판CD40 L형광강도여조발관심병환자혈장TF、TFPI、TF／TFPI균정정상관（r분별위0．43、0．32、0．30，P균＜0．01）；혈소판CD40L형광강도여조발관심병환자혈장TF수평정독립정상관（B＝0．4，P＜0．01）、여조발관심병발병정독립정상관（B＝0．8，P＜0．01）。결론조발관심병환자혈소판CD40 L표체증강，고CD40 L수평가능통과촉진TF적표체이촉진조발관심병적발생발전。
Objective To explore variation and effect of the expression of CD 40 ligand(CD40L) on platelets in prema-ture coronary heart disease patients .Methods Selected 200 patients experienced coronary artery angiography due to chest congestion or pain as experimental subjects , which were divided as premature coronary heart disease group ( 140 cases of coronary artery stenosis shown on imaging ) and control group ( 60 cases without stenosis ) .Flow cytometry was used for measurement of mean fluorescence intensity about CD 40 L on platelets.Tissue factor (TF) and tissue factor pathway inhibi-tor ( TFPI) were detected by method of ELISA .Results In premature coronary heart disease group , the data of fluores-cence intensity[(19.3 ±6.1) a.u],TF in plasma[(70.0 ±9.5) ng/L],TFPI[(68.0 ±9.4)μg/L], TF/TFPI(1.3 ± 0.1) were collected.Furthermore, the figures were detected as(8.8 ±2.4) a.u,(55.3 ±7.5)ng/L,(59.3 ±7.7)μg/L, (0.9 ±0.1 ) in control group correspondingly .There was significant difference between two groups ( P<0.05 or P <0.01).It had revealed positive correlation between fluorescence intensity of CD 40L on platelets and TF in plasma, TFPI, TF/TFPI of premature coronary heart disease patients (r were 0.43, 0.32, 0.30;all P<0.01).In addition, fluorescence intensity of CD40L on platelets was independenty positive correlated with TF level in plasma (B=0.4, P<0.01) and onset (B=0.8, P<0.01) of premature coronary heart disease.Conclusions The expression of platelet CD40L shows an in-creasing trend in premature coronary heart disease patients .Besides, high level of CD40 L may accelerate the occurrence and development of premature coronary heart disease by stimulating the expression of TF .