活动期溃疡性结肠炎患者血小板功能与凝血纤溶功能的变化

目的研究活动期溃疡性结肠炎（ulcerative colitis,UC）患者的血小板功能及凝血纤溶功能的改变及其与病情严重程度的关系,并探讨各指标间变化的相关性。方法收集91例活动期UC住院患者与200名正常体检者进行血小板数量、血小板平均体积、凝血酶原时间、活化凝血酶原时间、D二聚体、纤维蛋白原检测,分别进行患病组与正常对照组、不同病情严重程度间的指标统计学分析,对差异具有统计学意义的指标进行相关性分析。结果活动期UC患者与正常对照组的血小板数量（P〈0.05）、血小板体积（P〈0.01）、D-二聚体（P〈0.01）和纤维蛋白原（P〈0.05）差异具有统计学意义,其余指标差异无统计学意义。根据病情严重程度不同,D二聚体的变化差异具有统计学意义。对差异具有统计学意义的指标进行相关性分析,D二聚体与纤维蛋白原的相关性高（r=0.586972）,并且具有统计学意义（P〈0.01）,另外血小板数量和纤维蛋白原的相关性也同样具有统计学意义（P〈0.01）,其余指标间无明显相关性。结论血小板数量、血小板体积、D二聚体、纤维蛋白原异常可作为疾病活动期的预测指标,D二聚体可随病情加重而增加。     

溃疡性结肠炎患者血小板计数及其部分形态学参数的临床意义

目的 探讨溃疡性结肠炎(UC)患者的血小板(PLT)计数及其部分形态学参数指标的临床意义.方法 收集UC患者132例(UC组)及接受结肠镜检查的功能性肠病患者208例(对照组),比较其PLT计数、平均血小板体积(MPV)、大血小板比率(LPLT％)、C反应蛋白(CRP)、纤维蛋白原(Fib)及血浆D-二聚体(D-D)水...     

溃疡性结肠炎患者凝血功能的改变

目的分析活动期溃疡性结肠炎患者的凝血功能。方法以我院60例活动性溃疡性结肠炎及20例健康对照为检测对象,检测指标包括外周血血小板计数、部分凝血活酶时间及纤维蛋白原定量。结果与健康对照组比较,溃疡性结肠炎组血小板计数、纤维蛋白原定量均明显增高,差异具有统计学意义（P〈0．05）,在轻度、中度、重度之间,上述三个检测指标无差异（P〉0．05）。结论活动性溃疡性结肠炎患者处于高凝状态,疾病的严重程度与凝血功能无关。     

溃疡性结肠炎患者血小板功能变化的观察

目的 了解溃疡性结肠炎（ulcerative colitis，UC）患者血小板功能状态的变化及其与疾病的关系。方法对2006年住院的20例治疗前后血小板计数、平均体积（MPV）、聚集率进行分析。结果患者治疗前平均血小板计数385．61×10^12／L。治疗后192．67×10^12／L，差异无统计学意义（P〉0．05）。治疗前后血小板平均体积进行比较：治疗前9．53fl，治疗后11．58fl，两组数据有统计学意义（P〈0．01）。治疗前血小板最大聚集率0．65，治疗后0．30，两者有统计学意义（P〈0．01）。不同严重程度病人之间血小板聚集率及血小板平均体积差别具有统计学意义（P〈0．01），而未发现血小板计数与病情的关系（P〉0．05）。计算活动期、缓解期病人血小板聚集率、血小板平均体积与血小板计数三者的相关系数，并进行统计学检验，未见相关（P〉0．05）。结论 血小板功能状态的改变可能是UC肠道病变活动性的指标之一，并能反映疾病的程度。     

溃疡性结肠炎患者血小板功能状态的研究

目的　了解活动性溃疡性结肠炎患者的血小板功能状态。方法　采用ELISA法和单克隆酶联免疫吸附法测定 2 6例溃疡性结肠炎患者及 2 4例健康对照者的血浆内血小板a颗粒膜蛋白 (GMP - 140 )、血栓烷B2(TXB2 )、6 -酮 -前列腺素F1α(6 -keto -PGF1α)和血管性假血友病因子相关抗原 (vWF∶Ag)水平。结果　活动性溃疡性结肠炎患者血浆GMP - 140、TXB2 和vWF∶Ag水平均明显高于正常对照组 (P <0 0 1) ,6 -keto -PGF1α明显低于对照组 (P <0 0 1) ,血浆GMP - 140与vWF∶Ag呈正相关 (P <0 0 5 )。结论　活动性溃疡性结肠炎患者血小板活性增强 ,内皮细胞明显受损 ,应用抑制血小板活性药物 ,可作为溃疡性结肠炎的治疗措施之一     

丹参对溃疡性结肠炎病人血小板功能的影响

近来的研究表明 ,溃疡性结肠炎 (ＵＣ)病人存在高凝状态 ,血栓栓塞的危险性增加。在这一病理变化中 ,血小板不仅参与了血液凝固的各个环节 ,还与炎症的发生发展有密切关系。为进一步了解ＵＣ病人的血小板活性和内皮损伤情况 ,我们采用ＥＬＩＳＡ法和单克隆酶联免疫吸附法检测了 4 8例病人和 34例健康对照者的血小板α颗粒膜蛋白 (ＧＭＰ 14 0 )、血栓烷Ｂ2 (ＴＸＢ2 )、6 酮 前列腺素Ｆ1α(6 ｋｅｔｏ ＰＧＦ1α)和血管性假血友病因子相关抗原 (ｖＷＦ :Ａｇ)水平 ,并与对照组相比较 ,同时采用丹参治疗后观察上述指标的变化 ,以了解该病活…     

溃疡性结肠炎患者血小板α颗粒膜蛋白和血小板平均容积检测及临床意义

目的 探讨血小板α颗粒膜蛋白（GMP-140）和血小板平均容积（MPV）在溃疡性结肠炎（UC）发生发展中的作用。方法 检测67例UC患者（观察组）及30例健康人（对照组）血清GMP-140水平和MPV,分析两者与UC病情的相关性。结果 观察组GMP-140水平明显高于对照组（P〈0．05）,活动期患者明显高于缓解期患者（P〈0．05）;观察组MPV明显低于对照组（P〈0．05）,活动期患者明显低于缓解期患者（P〈0．05）;UC病情为重度、中度患者GMP-140水平明显高于轻度者（P〈0．05）、重度者明显高于中度者（P〈0．05）;重度、中度患者MPV明显低于轻度组（P〈0．05）、重度者明显低于中度者（P〈0．05）。结论 GMP-140和MPV可反映UC的病情活动性及严重程度。     

溃疡性结肠炎患者外周血BPC和MPV的变化及意义

检测56例活动期溃疡性结肠炎（UC）患者（实验组）及30例健康对照者（对照组）外周血血小板计数（BPC）和平均体积（MPV）。56例UC患者经用艾迪沙治疗后缓解37例（缓解组）,同样方法检测其外周血中的BPC和MPV。结果缓解组、实验组BPC及MPV明显高于对照组（P〈0．05,P〈0．01）,实验组明显高于缓解组（P〈0．05）;实验组不同程度UC患者BPC及MPV比较,P均〈0．05。认为活动期UC患者外周血BPC及MPV明显升高,BPC及MPV可作为评价UC活动度及其严重程度的参考指标。     

溃疡性结肠炎患者P-选择素和血小板参数分析

背景：研究发现凝血机制活化在炎症性肠病（IBD）的进展过程中起重要作用。P-选择素（CD62P）参与介导凝血和炎症反应时中性粒细胞和单核细胞与活化的血小板或内皮细胞的黏附。目的：探讨血小板活化标记物P．选择素以及血小板计数（PLT）、平均血小板体积（MPV）用于溃疡性结肠炎（UC）疾病活动度评估的价值。方法：纳入65例活动期UC患者、31例缓解期UC患者和60例健康对照者。流式细胞术测定外周血P-选择素阳性率,血细胞分析仪测定PLT、MPV,分析三者与UC活动度的相关性。结果：UC患者外周血CD62P阳性率、PLT显著高于对照组（P〈0．01）,MPV显著低于对照组（P〈0．01）;活动期UC患者三项指标的变化均较缓解期UC患者更为显著,组间差异有统计学意义（P〈0．05）。外周血CD62P、PLT与UC活动度呈正相关（P〈0．05）,MPV与UC活动度呈负相关（P〈0．05）。结论：UC患者的机体处于高凝状态。P-选择素、PLT、MPV能反映UC疾病活动度,对病情评估和治疗方案的制定有一定参考价值。     

Reticulated platelet levels in patients with ulcerative colitis

Background and aims In this study, we investigated whether reticulated platelets (RP) would be useful markers in the evaluation of ulcerative colitis (UC) activity and also aimed to gain indirect information about the platelet kinetics. Materials and methods Complete blood count, C-reactive protein, erythrocyte sedimentation rate, and proportion of RP were measured in 16 active, 21 inactive UC patients, and 20 healthy blood donors. UC activity was assessed by Truelove–Witts criteria. Results Mean platelet count was increased in patients with active compared to inactive UC (p = 0.008) or healthy donors (p = 0.000). Mean platelet volume (MPV) was significantly decreased in patients with active compared to inactive (p = 0.015) and healthy donors (p = 0.001). RP values was significantly decreased in active and inactive UC groups compared to healthy donors (p = 0.000, p = 0.000, respectively), while there was no significant difference between active and inactive UC patients (p = 0.980). Significant negative correlation between platelet count and MPV in patients with active UC (r = −0.542, p = 0.030) was observed. Conclusions RP values is reduced in active and inactive UC patients compared to healthy donors. To our knowledge, this is the first study about proportion of RP with UC in literature. However, the role of low RP values have not been determined clinically. Further studies are needed to evaluate the role of platelet abnormalities and changes in megakaryopoiesis caused by inflammatory state on low MPV and RP values during the course of UC.     

溃疡性结肠炎患者血栓前状态分子标志物的变化及其临床意义

目的探讨溃疡性结肠炎（UC）患者凝血、抗凝及纤溶指标的变化与溃疡性结肠炎的活动性及病变范围的关系。方法采用ELISA法检测32例活动期UC患者,20例缓解期UC患者及45例健康对照组的血小板颗粒膜蛋白-140（GMP-140）,血管性假性血友病因子（vWF：Ag）,血栓调节蛋白（TM）,D-二聚体（DD）的含量,采用发色底物法测定抗凝血酶-Ⅲ：活性（AT-Ⅲ：A）并进行分析。结果活动期UC患者GMP-140,vWF：Ag,TM,D-D的含量均明显高于缓解期患者及对照组,缓解期UC患者血栓前状态分子标志物水平明显高于对照组,而AT-Ⅲ：A在活动期UC患者明显低于缓解期患者及对照组。不同病变部位的活动期UC患者血栓前状态标志物水平有明显差异,活动期与缓解期UC患者各指标之间呈显著相关。结论UC患者处于明显的血栓前状态,血栓前状态分子标志物水平与病变活动性及病变范围有关,持续的高凝状态可能与UC患者的临床进展有关。     

Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing,which can be predicted from the platelet count

AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1.METHODS: UC patients with sustained clinical remission of 6 mo or more at the time of colonoscopy were examined for clinical outcomes and the hazard ratios of clinical relapse according to MES. Parameters, including blood tests, to identify predictive factors for MES 0 and slight endoscopic recurrence in clinically stable patients were assessed. Moreover, a receiver operating characteristic curve was generated, and the area under the curve was calculated to indicate the utility of the parameters for the division between complete and partial mucosal healing. All P values were two-sided and considered significant when less than 0.05.RESULTS: A total of 183 patients with clinical remission were examined. Patients with MES 0 (complete mucosal healing: n = 80, 44%) were much less likely to relapse than those with MES 1 (partial mucosal healing: n = 89, 48%) (P < 0.0001, log-rank test), and the hazard ratio of risk of relapse in patients with MES 1 vs MES 0 was 8.17 (95%CI: 4.19-17.96, P < 0.0001). The platelet count (PLT) < 26 × 10⁴/μL was an independent predictive factor for complete mucosal healing (OR = 4.1, 95%CI: 2.15-7.99). Among patients with MES 0 at the initial colonoscopy, patients of whom colonoscopy findings shifted to MES 1 showed significant increases in PLT compared to those who maintained MES 0 (3.8 × 10⁴/μL vs -0.6 × 10⁴/μL, P < 0.0001).CONCLUSION: The relapse rate differed greatly between patients with complete and partial mucosal healing. A shift from complete to partial healing in clinically stable UC patients can be predicted by monitoring PLT.     

Basophilia of the peripheral blood in patients with ulcerative colitis

Abstract

Background: Basophilia of the peripheral blood (PBB) has rarely been described in patients with ulcerative colitis (UC).

Objective: This study aimed to determine the frequency of PBB in patients with UC and to examine a potential correlation of PBB with markers of inflammation.

Methods: We compared retrospectively the basophil counts and the occurrence of basophilia (>200 basophils/µL) between 165 patients with UC and 35 controls, and analysed the correlation between the basophil count and the C-reactive protein (CRP).

Results: Within the study period, data from 1750 leukocyte differential count determinations of UC patients and 158 results from control subjects were available in the medical records and were statistically analysed. The differences in the basophil counts between the UC and the control group were not statistically significant (60/µL (0–351) vs. 49/µL (0–184), p?=?.26). Basophilia was apparent in 23 measurements of 10 patients with UC, but was not observed in the controls (p?=?.30). The basophil count was not significantly correlated with the CRP (p?=?.065, r?=?0.04).

Conclusions: Our findings suggest that PBB represents an uncommon and not disease-specific laboratory feature of UC. It is not correlated with the CRP and may not represent a useful biomarker for disease monitoring in UC.     

Clinical significance of serum procalcitonin in patients with ulcerative colitis

AIM:To investigate the association of procalcitonin(PCT)with ulcerative colitis(UC)activity.METHODS:Serum PCT levels,C-reactive protein(CRP)levels,the erythrocyte sedimentation rate,and the white blood cell count were analyzed in 18 patients with UC and 11 healthy volunteers.Serum PCT levels were analyzed by an electrochemiluminescence immunoassay.Severity assessments were based on Truelove and Witts’severity index.Correlation of serum PCT and CRP levels with UC activity was examined.Moreover,we assessed serum PCT and CRP levels in patients with a Mayo endoscopic subscore.RESULTS:Serum PCT levels in severe UC patients(n=7)(0.096±0.034 ng/mL)were significantly higher than in mild-to-moderate UC patients(n=11)(0.033±0.012 ng/mL)and healthy volunteers(n=11)(0.035±0.005 ng/mL)(P=0.0005 and P<0.0001,respectively).In addition,there was no difference in serum PCT levels between mild-to-moderate UC patients and healthy volunteers.Interestingly,patients with a Mayo endoscopic subscore of 3 points displayed significantly increased levels of serum PCT(0.075±0.043 ng/mL)compared with patients with a subscore of 2 points(0.03±0.011 ng/mL)(P=0.0302).Moreover,CRP levels in patients with severe UC or a Mayo endoscopic subscore of 3 points were not significantly higher than in patients with mild-to-moderate UC or a Mayo endoscopic subscore of 3 points.CONCLUSION:Serum PCT levels were significantly correlated with UC activity.     

溃疡性结肠炎患者白细胞介素-6活性研究

目的探讨白细胞介素-6(IL-6)在溃疡性结肠炎(UC)中的表达水平.方法以外周血单核细胞(PBMC)体外培养诱生IL-6.以B9细胞与培养液共育,测定IL-6水平,将健康人(HC)与UC患者进行比较研究,其中HC组20例,UC组25例(静止期与轻、中、重组,例数分别为5、10、6、4例).结果UC组与对照组IL-6活性分别为(261.48±82.01)U/ml和(100.00±57.65)U/ml,两者差异有非常显著性(P＜0.001).UC组静止期与轻、中、重三组比较IL-6活性依次为(121.06±43.00)U/ml、(240.23±61.60)U/ml、(275.83±78.40)U/ml及(315.00±142.92)U/ml,P值分别小于0.02、0.02及0.1.而静止期与对照组相比差异无显著性(P＞0.05).按病变累及范围,全结肠组与左半结肠组IL-6活性分别为(312.33±107.34)U/ml和(244.88±69.97)U/ml,两组间差异无显著性(P＞0.05).结论UC活动期患者IL-6活性明显高于对照与静止期患者,且随病情加重呈上升趋势.IL-6活性与病变累及范围无关.``     

溃疡性结肠炎的临床特点和治疗转归

目的分析溃疡性结肠炎患者的临床特点,探讨评价诊断方法、临床疗效及转归。方法回顾性分析自1989年10月至2005年6月在北京大学第三医院消化科住院的所有溃疡性结肠炎病例。填写调查表,统计病人的症状、诊断、分期、分型及治疗效果。结果共155例病人入选,男女比例为1·54∶1。平均年龄是41·8岁;发病高峰年龄20~30岁(44例,28·4%)。肠外表现较少见(12·9%)。轻度占32·3%,中度占41·3%,重度26·5%。病变范围以全结肠炎型最多(52·9%),分型以慢性复发型最多(39·4%),大部分病人都可以通过临床、内镜及病理(72·9%)得到确诊,病人经过内科保守治疗大多数都能缓解,少数需要手术治疗(4·5%),没有死亡病例。结论本组病人以轻中型为主,内科疗效较好,部分中重型病人需要使用激素和免疫抑制剂治疗,并发症(20例,12·9%)发生率和手术率(7例,4·5%)较低。     

溃疡性结肠炎患者肠神经内分泌细胞的观察

目的：观察溃疡性结肠炎患者肠切除标本中神经内分泌细胞的变化。方法：应用免疫组织化学和形态计量学方法。结果：病变肠组织VIP能神经，S-100蛋白及神经特异性烯醇化酶免疫阳性神经元、神经纤维形态异常，其线密度（Lv％）、体密度（Vv％）增高（分别P＜0．01）。生长抑素、血清素免疫阳性细胞及肠嗜银细胞数量明显减少（分别P＜0．01）。结论：肠神经内分泌细胞的异常可能参与溃疡性结肠炎的发生和发展。     

白介素-1 7在溃疡性结肠炎表达的研究

目的研究白介素-17(IL-17)在溃疡性结肠炎(UC)的表达和分泌及与疾病活动性的关系.方法用ELISA法测定UC患者及正常对照者血清或细胞培养液中,IL-17、IL-6和IL-8的浓度,逆转录聚合酶链反应(RT-PCT)测定IL-17mRNA的表达.结果32例UC患者外周血中IL-17,IL-6和IL-8的浓度与40例正常对照者比较,差异无显著性(P＞0.05),但外周血CD+4T细胞在PMA和抗CD3的刺激下,表达IL17mRNA及分泌IL-17的水平均明显高于对照组[(23.6±5.7)pg/ml和(13.1±3.2)pg/ml,P＜0.01].UC患者病变部位的黏膜固有层CD+4T细胞(LP-CD+4T)与非受累部位的LP-CD+4T细胞比较,它们表达大量的IL-17mRNA并自发分泌大量的IL-17蛋白,且IL-17浓度与该部位的单个核细胞(LPMC)分泌的IL-6,以及患者外周血中的C-反应蛋白,血沉均呈显著正相关.在刺激剂的作用下,病变部位的LP-CD+4T细胞IL-17的分泌进一步增加,且明显高于非受累部位LP-CD+4T细胞的分泌水平.另外,UC病变部位LPMC分泌的IL-6和IL-8的水平均明显高于非受累部位的LPMC,但在培养液中加入抗IL-17单克隆抗体后,LPMC细胞IL-6和IL-8的分泌均明显被抑制.结论UC患者病变部位的LP-CD+4T细胞表达和分泌IL-17明显增加,并与疾病的活动性呈正相关.抗IL-17抗体可明显抑制LMPC产生炎性细胞因子.IL-6和IL-8.结果说明,IL-17在UC肠道的炎症病理中起重要作用;阻断IL-17的分泌可能是治疗UC的一种有效手段.     

溃疡性结肠炎的临床特点和治疗转归

目的分析溃疡性结肠炎患者的临床特点，探讨评价诊断方法、临床疗效及转归。方法回顾性分析自1989年10月至2005年6月在北京大学第三医院消化科住院的所有溃疡性结肠炎病例。填写调查表，统计病人的症状、诊断、分期、分型及治疗效果。结果共155例病人入选，男女比例为1．54：1。平均年龄是41．8岁；发病高峰年龄20—30岁（44例，28．4％）。肠外表现较少见（12．9％）。轻度占32．3％，中度占41．3％，重度26．5％。病变范围以全结肠炎型最多（5209％），分型以慢性复发型最多（3904％），大部分病人都可以通过临床、内镜及病理（7209％）得到确诊，病人经过内科保守治疗大多数都能缓解，少数需要手术治疗（4．5％），没有死亡病例。结论本组病人以轻中型为主，内科疗效较好，部分中重型病人需要使用激素和免疫押制剂治疗，并发症（加例，12．9％）发生率和手术率（7例，4．5％）较低。