Pamuk Gülsüm E, Vural Ozden, Turgut Burhan, Demir Muzaffer, Umit Hasan, Tezel Ahmet
Department of Hematology, Trakya Medical Faculty, University of Trakya, Edirne, Turkey.
Am J Hematol. 2006 Oct;81(10):753-9. doi: 10.1002/ajh.20655.
It is reported that the incidence of thromboembolism is increased in ulcerative colitis (UC), and hypercoagulability persists even when patients are in remission. We evaluated the association of inflammatory response parameters with UC activity, and activation parameters of the platelets, endothelium, and the coagulation system in UC. Eighteen UC patients and 19 healthy subjects were included in the study. The patients' clinical features were recorded down; whole blood counts and acute phase parameters were evaluated. UC patients were divided into two as active (9 patients) and inactive (9 patients) according to combined clinical activity index (CAI) and endoscopic activity index (EAI) scores. In all subjects, platelet CD62P expression, platelet-monocyte complexes (PMC), platelet-neutrophil complexes (PNC), and platelet microparticles (PMP) were determined by flow cytometry. E-selectin, thrombin-antithrombin complex (TAT) levels in plasma, and sCD40L levels in serum were determined by ELISA. In both active and inactive UC patients, platelet CD62P expression, the percentages of PMC, and PNC were significantly higher than those in the control group (P< 0.01). PMP level was higher in the control group than in inactive UC patients (P = 0.001). sCD40L level was significantly higher in active UC group than in the control group (P < 0.01). EAI score correlated significantly with PMP (r = 0.5, P = 0.04) and sCD40L (r = 0.48, P = 0.044); CAI score had a negative correlation (r = -0.68, P = 0.002) with sE-selectin level. In addition to increased CD62P expression and sCD40L, increased formation of PMC and PNC suggests a role for platelet-leukocyte complex formation together with platelet activation in thromboembolic events observed in UC.
据报道,溃疡性结肠炎(UC)患者血栓栓塞的发生率增加,即使患者处于缓解期,高凝状态仍持续存在。我们评估了炎症反应参数与UC活动度、UC患者血小板、内皮细胞及凝血系统激活参数之间的关联。本研究纳入了18例UC患者和19名健康受试者。记录患者的临床特征;评估全血细胞计数和急性期参数。根据联合临床活动指数(CAI)和内镜活动指数(EAI)评分,将UC患者分为活动期(9例)和非活动期(9例)两组。采用流式细胞术测定所有受试者血小板CD62P表达、血小板-单核细胞复合物(PMC)、血小板-中性粒细胞复合物(PNC)及血小板微粒(PMP)。采用酶联免疫吸附测定法(ELISA)测定血浆E-选择素、凝血酶-抗凝血酶复合物(TAT)水平及血清可溶性CD40配体(sCD40L)水平。活动期和非活动期UC患者的血小板CD62P表达、PMC及PNC百分比均显著高于对照组(P<0.01)。PMP水平在对照组高于非活动期UC患者(P = 0.001)。活动期UC组sCD40L水平显著高于对照组(P < 0.01)。EAI评分与PMP(r = 0.5,P = 0.04)及sCD40L(r = 0.48,P = 0.044)显著相关;CAI评分与可溶性E-选择素水平呈负相关(r = -0.68,P = 0.002)。除了CD62P表达和sCD40L增加外,PMC和PNC形成增加提示在UC中观察到的血栓栓塞事件中,血小板-白细胞复合物形成以及血小板激活共同发挥作用。