活动期溃疡性结肠炎凝血功能分析

背景：血栓栓塞是溃疡性结肠炎（UC）较严重的并发症之一，了解活动期UC凝血状态，可为治疗提供参考依据。目的：分析UC活动期患者凝血功能的变化，探讨其与疾病活动性和严重程度的关系。方法：选取2006年1月～2012年11月上海中医药大学附属普陀医院收治的UC患者162例。检测患者血小板计数（PLT）、平均血小板体积（MPV）、凝血酶原时间（胛）、活化部分凝血活酶时间（APTr）、纤维蛋白原（FIB）、凝血酶时间（r丌）、D-二聚体（D-D）、红细胞沉降率（ESR）、C反应蛋白（CRP），评估患者临床活动性指数（CAI）和Baron内镜下评分。比较PLT、MPV、PT、APTT、FIB、Tr、D-D在UC不同疾病活动性和不同严重程度间的差异，分析UC活动期PLT、MPV、PT、FIB、D-D与ESR、CRP、CAI、Baron评分的相关性。结果：UC活动期组与缓解期组、正常对照组的PLT、MPV、FIB、D-D相比差异有统计学意义（P〈0．05）。轻、中、重度UC间D-D相比差异有统计学意义（P〈0．05）。Spearman等级相关分析显示，UC活动期患者PLT和D-D与ESR、CAI、Baron评分呈正相关，MPV与ESR、Baron评分呈负相关，PT和D-D与CRP呈正相关，FIB与ESR、CRP、Baron评分呈正相关（P〈0．05）。多元回归分析结果显示，UC活动期患者MPV与Baron评分呈负相关，FIB与ESR和CRP呈正相关，D-D与ESR和CRP呈正相关（P〈0．05）。结论：PLT、MPV、PT、FIB、D-D可作为评价UC活动性的指标，D-D可作为评价UC严重程度的指标。

Analysis of Coagulation Function in Active Ulcerative Colitis Patients

Background： Thromboembolism is one of the serious complications of ulcerative colitis （UC） and understanding blood coagulation state in active UC patients can provide references for its treatment. Aims： To analyze the coagulation function in active UC patients and analyze the relationship between coagulation function and activity, severity of UC. Methods： A total of 162 patients with UC from January 2006 to November 2012 at Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled. Platelet count （PLT）, mean platelet volume （MPV）, prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （FIB）, thrombin time （TT）, D-dimer （D-D）, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） were determined, clinical activity index （CAI） and Baron endoscopic score were evaluated. The differences of PLT, MPV, PT, APTT, FIB, TT and D-D between patients with different active stages and severity of UC were compared, and the correlation between PLT, MPV, PT, FIB, D-D and ESR, CRP, CAI as well as Baron score were analyzed. Results： PLT, MPV, FIB and D-D were significantly different between active UC group and remissive UC group, control group （ P 〈 0.05 ）. D-D was significantly different between mild, moderate and severe UC groups （P 〈 0.05 ）. Spearman rank correlation coefficient showed that PLT and D-D were positively correlated with ESR, CAI and Baron score, MPV was negatively correlated with ESR and Baron score, PT and D- D were positively correlated with CRP, and FIB was positively correlated with ESR, CRP and Baron score in active UC patients （ P 〈 0.05 ）. Multiple regression analysis showed that MPV was negatively correlated Baron score, FIB was positively correlated with ESR and CRP, and D-D was positively correlated with ESR and CRP in active UC patients （P 〈 0.05）. Conclusions： PLT, MPV, PT, FIB and D-D can be used to evaluate the activity of UC, and D-D can be used to evaluate the severity of UC.