The Clinical Study On Relationship Among Serum SCD40L, Carotid Artery Plaque And Ischemic Cerebrovascular Disease

Objective By measuring the level of serum soluble CD40 ligand(sCD40L) and the stability of carotid artery plaque in acute stage of ischemic cerebrovascular disease, and following up for one year, to observe the relationship between sCD40L and the stability of carotid artery plaque, while analyse the association between sCD40L and occurrence and recurrence of ischemic cerebrovascular disease, To explore the mechanism that CD40/CD40L dyad participate in ischemic cerebrovascular disease, to estimate the predictive role of sCD40L in. occurrence and recurrence of acute ischemic cerebrovascular diseaseMethods 112 patients with acute ischemic cerebrovascular disease for the first time were selected as cerebral infarction group, and 40 persons without cerebrovascular disease were selected as control group. In 48 hours after attacked cerebral infarction, all subjects were detected whether there were ischemic focus in brain tissues by CT/MRI, and plaque echogenicity and morphology were evaluated bilaterally by carotid ultrasonography. According to the results, all patients in cerebral infarction group were divided into three subgroups, including unstable plaque group(24 cases), stable plaque group(40 cases) and non-plaque group(48 cases). The serum level of sCD40L in all subjects while occurred first were measured by enzyme-linked immunosorbent assay. All patients from cerebral infarction group were followed up for one year to observe relapse events by telephone or in outpatient department.Results①The serum level of sCD40L in cerebral infarction group(3.82±1.04ng/ml) were significantly higher than that in control group(2.69±0.49ng/ml) (P<0.05).②For patients with anterior circulation infarction, the serum level of sCD40L in unstable plaque group(5.21±1.08ng/ml) were significantly higher than that in stable plaque group(3.83±0.57ng/ml)(P<0.05), and were both significantly higher than that in non-plaque group(3.07±4.29ng/ml)(P<0.05).③8 of 112 patients in cerebral infarction group relapsed during one-year follow-up. The serum level of sCD40L while occurred first in relapse patients(5.87±0.72ng/ml) were significantly higher than that in non-relapse patients(3.49±0.67ng/ml)(P<0.01).Conclusions Serum sCD40L maybe participate the development of stable carotid atherosclerosis plaque to unstable by promoting plaque rupture, which can lead to occurrence and recurrence of ischemic cerebrovascular disease. So, the serum level of sCD40L has certain prediction for occurrence and recurrence of ischemic cerebrovascular disease by mediating destabilization and disruption of carotid atherosclerosis plaque.