Collins C E, Cahill M R, Newland A C, Rampton D S
Gastrointestinal Science Research Unit, London Hospital Medical College, Whitechapel, England.
Gastroenterology. 1994 Apr;106(4):840-5. doi: 10.1016/0016-5085(94)90741-2.
BACKGROUND/AIMS: Platelets show proinflammatory as well as prothrombotic properties. Patients with inflammatory bowel disease are at increased risk of systemic thromboembolism, and multifocal microvascular infarction has been proposed as a pathogenetic mechanism in Crohn's disease. The aim of this study was to determine if inflammatory bowel disease is associated with abnormal platelet behavior.
Platelet activation and aggregability were assessed using flow cytometry, Born aggregometry, and the modified method of Wu and Hoak. Serum beta-thromboglobulin was measured in patients with Crohn's disease and ulcerative colitis and, as controls, in healthy volunteers and patients with active rheumatoid arthritis.
Platelet surface expression of P-selectin and GP53 (markers of activation) were increased in Crohn's disease (13 of 30 patients abnormal for P-selectin; 9 of 28 abnormal for GP53) (P < 0.01) and ulcerative colitis (9 of 21 for P-selectin; 10 of 21 for GP53) (P < 0.01) compared with healthy controls. Increased circulating platelet aggregates (15 of 24 patients with Crohn's disease and 8 of 16 with ulcerative colitis) (P < 0.01), platelet aggregability in vitro, and serum beta-thromboglobulin were detected in active inflammatory bowel disease compared with healthy controls. Platelet behavior in active rheumatoid arthritis resembled that in healthy controls.
Increased platelet activation and aggregation are features of inflammatory bowel disease and may contribute to the risk of systemic thromboembolism and the pathogenesis of mucosal inflammation. Therefore, antiplatelet agents may be valuable in the management of inflammatory bowel disease.
背景/目的：血小板具有促炎和促血栓形成特性。炎症性肠病患者发生系统性血栓栓塞的风险增加，多灶性微血管梗死被认为是克罗恩病的发病机制之一。本研究旨在确定炎症性肠病是否与血小板行为异常有关。
采用流式细胞术、玻恩氏比浊法及改良的吴和霍克法评估血小板活化和聚集能力。检测克罗恩病和溃疡性结肠炎患者血清β-血小板球蛋白水平，健康志愿者和活动性类风湿关节炎患者作为对照。
与健康对照相比，克罗恩病患者（30例中13例P-选择素异常；28例中9例GP53异常）（P<0.01）和溃疡性结肠炎患者（21例中9例P-选择素异常；21例中10例GP53异常）（P<0.01）血小板表面P-选择素和GP53（活化标志物）表达增加。与健康对照相比，活动性炎症性肠病患者循环血小板聚集体增加（克罗恩病24例中15例，溃疡性结肠炎16例中8例）（P<0.01），体外血小板聚集能力及血清β-血小板球蛋白水平升高。活动性类风湿关节炎患者的血小板行为与健康对照相似。
血小板活化和聚集增加是炎症性肠病的特征，可能增加系统性血栓栓塞风险及黏膜炎症的发病机制。因此，抗血小板药物可能对炎症性肠病的治疗有价值。
