Research Of Dependablity Among Levels Of Serum Bilirubin, Serum SCD40L And Carotid Atherosclerotic Plaque

Objective:To discuss the relationship among the Levels of serum bilirubin,soluble sCD40L and carotid atherosclerotic plaque,and the predicting meaning of the two parameters for ischemic stroke caused by atherosclerosis.Methods:Adopt case-control study method to test.According to the condition of being selected,we chose 64 cases.In accordance with diagnostic criteria of CCCI and TIA,we selected 30 patients of them as CCCI group and 34 patients of them as TIA group.Meanwhile, 30 persons without ischemic cerebrovascular disease and carotid atherosclerotic plaque were selected as normal control group.They all underwent skull CT(or MRI),TCD and carotid ultrasound examination to detect whether there was ischemic focus in brain tissues and the condition of carotid atherosclerotic plaque.Serum sCD40L levels of all the subjects were measured by enzyme-linked immunosorbent assay and serum levels of bilirubin,low density lipoprotein(LDL) and hsCRP were batch tested by automatic biochemical analyser.Level of tHcy was measured by Axsym analyser.In the end,the above data was be analysed by statistics.Results:①In this sample reseach,carotid ultrasound examination indicate that probability distribution of plaque condition of CCCI group and TIA group is different and probability distribution of unstable plaque in TIA group is highcr than that of CCCI group.②The differences of the levels of serum sCD40L,direct bilirubin(Dbil)and LDL were significant (P＜0.01) among the three groups,yet there was no statistical differences(P＞0.05) of levels of serum totle bilirubin(Tbil) and indirect bilirubin(Ibil).③The levels of serum hsCRP,tHcy in TIA group comparing with normal control group and CCCI group increased apparently,but comparing of the two later groups had no statistical differences(P＞0.05).④Furthermore,the level of serum Dbil was negatively correlated with the levcls of serum sCD40L,hsCRP and tHey in the three groups(r=-0.62,r=-0.37,r=-0.45,P＜0.01),but was independent with tHcy(P =0.241＞0.05).The opposite relationship exist between the level of serum tHcy and LDL (r=0.27,0.05＞P＞0.01).Conclusion:①Direct bilirubin could inhibit formation of ox-LDL,protect cells from lipid peroxidative damage,and could inhibit the chronic inflammation progress of atherosclerotic plaque.②Serum direct bilirubin can restrain the occurance and development of atherosclerosis. That its level increases and level of sCD40L decreases can reflect the extent of carotid atherosclerosis,stability of plaque and risk of ischemic cerebrovascular disease.But that levels of hsCRP and tHcy step up can hint the formation of unstable plaque in carotid atery,so they can be applied as markers of formation of unstable plaque.③By testing the changes of above four serum parameters,we can realize the condition of carotid atherosclerotic plaque more reliably and predict the risk of ischemic cerebrovascular disease to guide the primary prevention of ischemic cerebrovascular disease more roundly.