Tsimperidis Achilleas G, Kapsoritakis Andreas N, Linardou Ioanna A, Psychos Athanassios K, Papageorgiou Athanassios A, Vamvakopoulos Nikos C, Kyriakou Despina S, Potamianos Spyros P
Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.
Scand J Gastroenterol. 2015 Jul;50(7):848-55. doi: 10.3109/00365521.2015.1010568. Epub 2015 Feb 5.
The aim of this study is to evaluate the role of thrombophilia-hypercoagulability in ischemic colitis (IC).
Thrombophilia and fibrinogen were evaluated in 56 cases of IC and 44 controls with known predisposing factors but no evidence of IC. Thrombophilic factors tested were: protein C (PC), protein S, antithrombin (AT), resistance to activated protein C (APCR), lupus anticoagulant (LA), factor V G1691A mutation (FV Leiden), prothrombin G20210A mutation, methylenetetrahydrofolate reductase (MTHFR) gene C677T and A1298C mutations and plasminogen activator inhibitor-1 (PAI-1) gene 5G/4G and 4G/4G polymorphisms.
In IC group were recorded: i) low levels of PC and AT (p = 0.064 and p = 0.022, respectively); ii) low levels of APCR (normal: >2, p = 0.008); iii) high levels of fibrinogen (p = 0.0005); iv) higher number of homozygotes for MTHFR A1298C and C677T mutations (p = 0.061 and p = 0.525 (Pearson chi-square), respectively); v) greater prevalence of 5G/4G and 4G/4G polymorphisms (p = 0.031 (Pearson chi-square)) and vi) higher incidence of LA-positive individuals (p = 0.037, Fischer's exact test). Multivariate analysis was performed to determine the effects of prothrombotic factors in IC. 5G/4G polymorphism of PAI-1 gene (odds ratio (OR) 12.29; 95% confidence interval (CI) 2.26-67.00), APCR (OR 0.089; 95% CI 0.011-0.699) and fibrinogen (OR 1.013; 95% CI 1.003-1.023) were determined as predictors of IC.
This study suggests that hypercoagulability, hereditary or acquired, plays an essential role in the manifestation of IC.
本研究旨在评估血栓形成倾向 - 高凝状态在缺血性结肠炎（IC）中的作用。
对56例IC患者和44例有已知易感因素但无IC证据的对照者进行血栓形成倾向和纤维蛋白原评估。检测的血栓形成倾向因素包括：蛋白C（PC）、蛋白S、抗凝血酶（AT）、活化蛋白C抵抗（APCR）、狼疮抗凝物（LA）、因子V G1691A突变（FV Leiden）、凝血酶原G20210A突变、亚甲基四氢叶酸还原酶（MTHFR）基因C677T和A1298C突变以及纤溶酶原激活物抑制剂 - 1（PAI - 1）基因5G/4G和4G/4G多态性。
在IC组中记录到：i）PC和AT水平较低（分别为p = 0.064和p = 0.022）；ii）APCR水平较低（正常：>2，p = 0.008）；iii）纤维蛋白原水平较高（p = 0.0005）；iv）MTHFR A1298C和C677T突变的纯合子数量较多（分别为p = 0.061和p = 0.525（Pearson卡方检验））；v）5G/4G和4G/4G多态性的患病率更高（p = 0.031（Pearson卡方检验））；vi）LA阳性个体的发生率更高（p = 0.037，Fischer精确检验）。进行多变量分析以确定促血栓形成因素在IC中的作用。PAI - 1基因的5G/4G多态性（比值比（OR）12.29；95%置信区间（CI）2.26 - 67.00）、APCR（OR 0.089；95% CI 0.011 - 0.699）和纤维蛋白原（OR 1.013；95% CI 1.003 - 1.023）被确定为IC的预测指标。
本研究表明，遗传性或获得性高凝状态在IC的表现中起重要作用。
