Wang Duoqin, Tang Hui, Shen Yanyun, Wang Fang, Lin Jinran, Xu Jinhua
Clin Lab. 2015;61(9):1283-8. doi: 10.7754/clin.lab.2015.150226.
Ninty-five percent of chronic spontaneous urticaria (CSU) patients presented with signs of thrombin generation, and autologous plasma skin tests score positive. The aim of this study was to assess the initiators of blood coagulation that lead to thrombin generation and fibrinolysis in CSU patients.
The plasma level of activated factor VII, activator factor XII, fragment F1+2, and D-dimer were measured and analyzed in 103 patients with CSU and 76 control subjects.
Mean D-dimer plasma levels were higher in patients than controls (0.41 ± 0.44 μg/mL vs. 0.21 ± 0.26 μg/ mL; p < 0.001). Mean F1+2 plasma levels were higher in patients than controls (11.17 ± 17.65 nM vs. 5.97 ± 9.42 nM; p = 0.048). Mean FVIIa plasma levels were higher in patients than controls (4.09 ± 4.22 ng/mL vs. 2.97 ± 1.59 ng/mL; p = 0.031). However, no significant difference was found on FXIIa plasma levels. On the other hand, all the coagulation factors (D-dimer, FVIIa, and F1+2) were significantly correlated with disease severity.
The extrinsic pathway of the clotting cascade is activated in CSU and is correlated with the disease severity. The involvement of the coagulation pathway in CSU opens new perspectives for a better understanding of the pathogenesis and treatment of the disease.
95%的慢性自发性荨麻疹（CSU）患者出现凝血酶生成迹象，且自体血浆皮肤试验呈阳性。本研究旨在评估导致CSU患者凝血酶生成和纤维蛋白溶解的凝血启动因子。
对103例CSU患者和76例对照者的活化因子VII、活化因子XII、片段F1+2和D-二聚体的血浆水平进行了测量和分析。
患者的平均D-二聚体血浆水平高于对照组（0.41±0.44μg/mL对0.21±0.26μg/mL；p<0.001）。患者的平均F1+2血浆水平高于对照组（11.17±17.65nM对5.97±9.42nM；p=0.048）。患者的平均FVIIa血浆水平高于对照组（4.09±4.22ng/mL对2.97±1.59ng/mL；p=0.031）。然而，FXIIa血浆水平未发现显著差异。另一方面，所有凝血因子（D-二聚体、FVIIa和F1+2）均与疾病严重程度显著相关。
CSU患者凝血瀑布的外源性途径被激活，且与疾病严重程度相关。凝血途径在CSU中的参与为更好地理解该疾病的发病机制和治疗开辟了新的视角。
