The Clinical Research Of Serum Souble CD40 Ligand In Acute Coronary Syndrome Patiens

BACKGROUND: Acute coronary syndrome (ACS) is a term used to describe a constellation of symptoms resulting from acute myocardial ischemia, based on the plaque rupture, vascular spasm, platelet adhesion, coronary thrombosis caused by a group of acute lesions . The level of immune response and inflammatory processes play a role in ACS . Immune molecules CD40 and its ligand (CD40L) in the role of atherosclerosis is now widely accepted , high concentrations of CD40L were recently shown to be associated with an increased risk of cardiovascular events in patients with an acute coronary syndrome.CD40 and CD40 ligand are tumor necrosis factor superfamily, they are the double role of thrombosis and inflammatory molecules ,Epidemiological studies have shown that inflammatory molecules as CD40 and its ligand system may be cardiovascular disease risk factors or other markers of disease . C-reactive protein have been verified to be an early warning indicators of stable and unstable populations which ACS occurs. as a target creatinine clearance, Cystatin C has been shown to participate in the pathophysiological process of cardiovascular disease and the risk of future events were independently associated, Currently on cystatin C levels and coronary disease are not many reports of relationships, many research results are contradictory. We will study the Clinical significance of the changes of serum sCD40L, hs-CRP and CysC in patients with acute acute coronary syndrome, and to explore whether they correlated with the severity of coronary artery disease and whether they can be used as indicators of disease prediction. Follow-up found that sCD40L and elevated hs-CRP increased the incidence of cardio vascular events, combined determination of sCD40L and hs-CRP maybe has a prognostic value.METHODS: 137 patiens with acute acute coronary syndrome which Continuoued hospitalization from cardiology Department of xijing hospital to Fourth Military Medical University from Oct 2009 to Jun 2010. They were divided into 2 groups: control group and ACS group. All patients were taken in the morning forearm venous blood were measured triglyceride, total cholesterol, high density lipoprotein and other routine biochemical parameters, concentrations of serum sCD40L, high sensitivity C-reactive protein and cysteine C were measured by enzyme-linked immunosorbent assay (ELISA) . All patients underwent coronary angiography child, with a diameter determined the extent of coronary artery stenosis, with the Gensini scoring system to rate, cumulative points.RESULT: The levels of high sensitivity C-reactive protein and sCD40L were obviously higher in the ACS group than in the control group(P﹤0.05), the levels of Cystatin C was lower in the ACS group than in the control group(P﹤0.05). sCD40L and high sensitivity C-reactive protein were positively correlated with the Gensini score respectively(r=0.328,p=0.000; r=0.748,p=0.000), these two markes were positively correlated each other(r=0.192,p=0.039). CONDUCTION: The levels of sCD40L and hs-CRP were increased in Patients with acute coronary syndrome, and the levels of CYsC was lower. sCD40L and hs-CRP levels and coronary artery disease were positively correlated, suggesting that CD40/CD40L system may plays an important role in atherosclerotic plaque instability, C-reactive protein and other inflammatory factors in synergy increased its expression. sCD40L and hs-CRP showed a relationship between the two and influence each other in collaborative CYsC play a role in the pathogenesis of ACS.