Department of Pediatrics, Medical University of Graz, Austria.
Inflamm Bowel Dis. 2011 Nov;17(11):2333-9. doi: 10.1002/ibd.21631. Epub 2011 Feb 1.
Patients with inflammatory bowel disease (IBD) have an increased risk of thromboembolic complications. The pathogenesis of IBD is not really clear and a high thrombin activity might contribute to the pathogenesis. We measured thrombin generation by means of calibrated automated thrombography (CAT), a new tool better reflecting overall hemostasis, in children with Crohn's disease (CD) during active and inactive disease and compared it to conventional markers of activity. We wanted to see whether children with CD have a higher potential for thrombin generation and if there is a correlation between hypercoagulability and disease activity.
Plasma samples were collected from 22 patients with CD and from 61 healthy children. Thrombin generation was measured by means of CAT. The disease activity was estimated using the Pediatric Crohn's Disease Activity Index (PCDAI). In addition, F1+2, TAT, tissue factor pathway inhibitor (TFPI), fibrinogen, prothrombin (FII), antithrombin (AT), erythrocyte sedimentation rate (ESR), platelet count, α2-globulin, and orosomucoide were measured.
In all patients we found a significantly higher endogenous thrombin potential (ETP) and higher peak values during active disease. In accordance with this we also found significantly higher mean ETP values during active disease compared with the control group. We observed a significantly positive correlation between PCDAI and thrombin generation parameters.
Our study clearly shows that the active state of CD in children is associated with the potential for high thrombin generation, but this seems to be caused mainly by the inflammatory process and not by a preexisting propensity for high thrombin generation.
炎症性肠病（IBD）患者发生血栓栓塞并发症的风险增加。IBD 的发病机制尚不清楚，高凝血酶活性可能有助于发病机制。我们通过校准自动化血栓描记术（CAT）测量了处于活动期和非活动期的克罗恩病（CD）患儿的凝血酶生成，并将其与常规的活动标志物进行了比较。我们想知道 CD 患儿是否具有更高的凝血酶生成潜力，以及高凝状态与疾病活动度之间是否存在相关性。
从 22 例 CD 患儿和 61 例健康儿童中采集血浆样本。通过 CAT 测量凝血酶生成。使用儿科克罗恩病活动指数（PCDAI）评估疾病活动度。此外，还测量了 F1+2、TAT、组织因子途径抑制物（TFPI）、纤维蛋白原、凝血酶原（FII）、抗凝血酶（AT）、红细胞沉降率（ESR）、血小板计数、α2-球蛋白和转铁蛋白。
在所有患者中，我们发现活动期的内源性凝血酶潜能（ETP）和峰值明显更高。与此一致，我们还发现活动期的平均 ETP 值明显高于对照组。我们观察到 PCDAI 与凝血酶生成参数之间存在显著正相关。
我们的研究清楚地表明，儿童 CD 的活动状态与高凝血酶生成潜力相关，但这似乎主要是由炎症过程引起的，而不是由高凝血酶生成倾向引起的。
