Van Bodegraven A A, Tuynman H A, Schoorl M, Kruishoop A M, Bartels P C
Dept. of Internal Medicine, Medical Centre Alkmaar, The Netherlands.
Scand J Gastroenterol. 1995 Jun;30(6):580-5. doi: 10.3109/00365529509089793.
Factor XIII (F XIII), the last coagulation factor in the clotting cascade, plays a role in mucosal repair. Beneficial effects of F XIII supplementation in severe ulcerative colitis (UC) have been observed. The aim of this study was to relate plasma F XIII activity to the severity of inflammatory bowel disease (IBD).
A transversional and, in part, longitudinal study of F XIII activity and related clotting products was performed in 39 patients with UC, 31 patients with Crohn's disease (CD), and 20 controls. Disease activity was assessed with a combined activity score in UC and with the Dutch Activity Index in CD.
F XIII activity was decreased in active UC (p < 0.05) and active CD (p < 0.05) and was inversely correlated with severity in both UC (r = -0.30) and CD (r = -0.46). In six patients with UC (15%) and six patients with CD (19%) F XIII activity was below the lower range of normal. In these patients apparent rectal bleeding was only found in severe UC. Hyperfibrinolysis was indicated by elevated levels of D-dimer (p < 0.001) notwithstanding increased concentrations of alpha-2 antiplasmin (p < 0.05).
In active IBD we found decreased plasma F XIII activity and hyperfibrinolysis. Decreased F XIII activity was not associated with apparent rectal bleeding in IBD.
凝血因子 XIII（F XIII）是凝血级联反应中的最后一个凝血因子，在黏膜修复中发挥作用。已观察到补充 F XIII 对重度溃疡性结肠炎（UC）有有益作用。本研究的目的是探讨血浆 F XIII 活性与炎症性肠病（IBD）严重程度之间的关系。
对 39 例 UC 患者、31 例克罗恩病（CD）患者和 20 例对照者进行了 F XIII 活性及相关凝血产物的横断面研究，并部分进行了纵向研究。UC 的疾病活动度采用综合活动评分评估，CD 采用荷兰活动指数评估。
活动期 UC（p < 0.05）和活动期 CD（p < 0.05）患者的 F XIII 活性降低，且与 UC（r = -0.30）和 CD（r = -0.46）的严重程度呈负相关。6 例 UC 患者（15%）和 6 例 CD 患者（19%）的 F XIII 活性低于正常范围下限。在这些患者中，明显的直肠出血仅在重度 UC 中发现。尽管α-2 抗纤溶酶浓度升高（p < 0.05），但 D-二聚体水平升高表明存在高纤溶状态（p < 0.001）。
在活动期 IBD 中，我们发现血浆 F XIII 活性降低和高纤溶状态。F XIII 活性降低与 IBD 中的明显直肠出血无关。
