中文摘要：

目的探讨急性冠脉综合征（ACS）患者血清可溶性CD40配体（sCD40L）和超敏C反应蛋白（hs-CRP）的水平及临床意义。方法按照诊断标准入选研究对象137例，分为两组：冠状动脉造影无异常者为对照组，21例，ACS组116例，男86例，30例，年龄35～77（56.9±12.6）岁，包括不稳定型心绞痛88例，急性心肌梗死28例。采集患者空腹肘静脉血，采用酶联免疫吸附（ELISA）方法测定血清sCD40L浓度和hs-CRP浓度。所有患者入院第2～4天行冠状动脉造影检查，用直径法测定冠状动脉狭窄的程度，用Gensini评分系统进行评分，累计积分。结果 ACS组sCD40L与hs-CRP水平均高于对照组（P＜0.05）。sCD40L水平与Gensini积分呈正相关关系（r＝0.328，P＝0.000），hs-CRP水平与Gensini积分呈正相关关系（r＝0.748，P＝0.000），sCD40L与hs-CRP之间呈正相关关系（r＝0.192，P＝0.039）。结论 ACS患者外周血清sCD40L和hs-CRP水平明显升高，提示CD40/CD40L系统与ACS的发生有关。

英文摘要：

Objective To determine the serum levels of soluble CD40 ligand （sCD40L） and high sensitivity C-reaction protein （hs-CRP） in patients with acute coronary syndrome （ACS） and their clinical significance. Methods A total of 116 ACS inpatients [86 males and 30 females;aged （58.4±10.4）years, ranging from 39 to 78 years] in the Department of Cardiology of Xijing Hospital from May to December 2011 were enrolled in this study. There were 88 cases of unstable angina and 28 cases of acute myocardial infarction. Another 21 patients with normal coronary angiography served as control group （n=21）. Fasting forearm venous blood samples were taken from all patients in the morning for the serum levels of sCD40L and hs-CRP by enzyme-linked immunosorbent assay （ELISA）. All patients underwent coronary angiography within 2 to 4 d after admission for the extent of coronary artery stenosis, which were further analyzed with the Gensini scoring system. Results The serum levels of hs-CRP and sCD40L were obviously higher in ACS group than in the controls （P〈0.05）. The serum levels of sCD40L and hs-CRP were positively correlated with the Gensini score respectively （r=0.328, P=0.000; r=0.748, P=0.000）. Positive correlation was also found between sCD40l and hs-CRP levels （r=0.192, P=0.039）. Conclusion The serum levels of sCD40L and hs-CRP are obviously increased in ACS patients, suggesting that CD40/CD40L system may be involved in the development of ACS.