Swiatkowski M, Grad K, Kłopocka M, Budzyński J, Zekanowska E, Kotschy M
Katedra i Klinika Gastroenterologii i Chorób Wewnetrznych AM im. L. Rydygiera w Bydgoszczy.
Pol Arch Med Wewn. 2000 Jan-Feb;103(1-2):47-51.
Hemostasis disturbances in patients with ulcerative colitis (uc) can result from quantity and quality changes in blood coagulation factors synthesis (acute phase reaction) as well as their consumption in inflammatory processes affecting in large bowel. The aim of this study was to estimate a coagulation system activation in patients with uc.
42 patients with uc, 21 in active and 21 in inactive disease phase as well as 26 healthy persons were studied. In all concentration of thrombin-antithrombin III complexes (TAT), antithrombin III and prekallikrein activities, von Willebrand factor (vWf) and fibrinogen concentrations, kaolin-kephalin time (aPTT), prothrombin level and platelets count were determined.
In patients with uc higher level of TAT, fibrinogen and platelets count, lower level of prekallikrein activity and shorter aPTT were found than in control group. No significant differences in obtained results of hemostatic parameters between patients with active and inactive uc were found. Whereas, it was disclosed lower platelets count and fibrinogen concentration in cases with inflammatory process only to rectum limited in comparison with more extended inflammatory changes. Using multiple regression method it was found that in studied group the TAT concentration, marker of thrombin in vivo generation, was determined by: aPTT, fibrinogen level, disease severity, inflammatory process extension in large bowel, systemic acute phase reaction.
溃疡性结肠炎(UC)患者的止血障碍可能源于凝血因子合成的数量和质量变化(急性期反应)以及它们在影响大肠的炎症过程中的消耗。本研究的目的是评估UC患者凝血系统的激活情况。
对42例UC患者(21例处于活动期,21例处于非活动期)以及26名健康人进行了研究。测定了所有人的凝血酶 - 抗凝血酶III复合物(TAT)浓度、抗凝血酶III和前激肽释放酶活性、血管性血友病因子(vWf)和纤维蛋白原浓度、高岭土 - 脑磷脂时间(aPTT)、凝血酶原水平和血小板计数。
与对照组相比,UC患者的TAT水平、纤维蛋白原和血小板计数更高,前激肽释放酶活性更低,aPTT更短。活动期和非活动期UC患者的止血参数结果无显著差异。然而,与炎症范围更广的情况相比,仅直肠有炎症的患者血小板计数和纤维蛋白原浓度较低。采用多元回归方法发现,在研究组中,体内凝血酶生成的标志物TAT浓度由以下因素决定:aPTT、纤维蛋白原水平、疾病严重程度、大肠炎症范围、全身急性期反应。
1)在UC患者中,无论炎症过程的活动程度和范围如何,均发现较高TAT水平所表示的体内凝血酶生成增加。2)观察到的凝血系统紊乱可能会影响大肠的炎症过程,并增加UC病程中血栓形成并发症的风险。