Department of Pediatrics, Nara Medical University School of Medicine, Kashihara, Nara 634-8522, Japan.
Allergy. 2011 Mar;66(3):428-33. doi: 10.1111/j.1398-9995.2010.02506.x. Epub 2010 Nov 17.
The pathogenesis of chronic spontaneous urticaria (CU) has recently been conceived to be associated with thrombin generation through the extrinsic coagulation pathway. However, little is known about the components of the intrinsic coagulation pathway potentially involved.
To investigate the whole process of coagulation, both classical coagulation assays and a global coagulation test, the intrinsic coagulation pathway-dependent activated partial thromboplastin time (APTT) clot waveform analysis, were performed using plasma of 36 patients with CU who had various severities.
Classical coagulation assays revealed that levels of fibrinogen, D-dimer, and fibrin and fibrinogen degradation products (FDP), and positive rates of soluble fibrin monomer complex (SFMC) were significantly elevated in patients with CU, whereas the elevation of prothrombin fragment 1 + 2 was not statistically significant. On the other hand, all parameters of a global coagulation test, APTT clot waveform analysis, evidently showed a hypercoagulable pattern and were significantly correlated to disease severity of CU.
CU is characterized by elevated blood coagulation potential with involvement of the intrinsic coagulation factors, which may contribute in vivo to the generation of fibrin even by small amounts of thrombin.
慢性自发性荨麻疹（CU）的发病机制最近被认为与通过外源性凝血途径生成的凝血酶有关。然而，目前对于潜在涉及的内在凝血途径的成分知之甚少。
为了研究凝血的全过程，对 36 例具有不同严重程度的 CU 患者的血浆进行了经典凝血检测和内在凝血途径依赖性激活部分凝血活酶时间（APTT）凝块波形分析的整体凝血检测。
经典凝血检测显示，CU 患者的纤维蛋白原、D-二聚体、纤维蛋白和纤维蛋白原降解产物（FDP）水平以及可溶性纤维蛋白单体复合物（SFMC）的阳性率显著升高，而凝血酶原片段 1+2 的升高则无统计学意义。另一方面，整体凝血检测的所有参数，即 APTT 凝块波形分析，均明显显示出高凝状态，并与 CU 的疾病严重程度显著相关。
CU 的特点是血液凝固潜能升高，涉及内在凝血因子，这可能有助于体内即使只有少量凝血酶也能产生纤维蛋白。
