凝血和纤溶状态的变化对炎症性肠病疾病活动性的影响

目的评价炎症性肠病患者及正常对照者之间凝血和纤溶状态的差异及其和疾病活动性的关系。方法队列研究271例炎症性肠病患者和正常对照者的凝血和纤溶状态,性别分层分析凝血和纤溶状态的改变和炎症活动性的关系。结果炎症性肠病患者血小板、血小板分布宽度、凝血酶原时间、纤维蛋白原和活化部分凝血活酶时间显著高于正常对照者（P〈0.05）,但平均血小板体积显著低于正常对照组（P〈0.05）。多元回归分析显示纤维蛋白原是男性溃疡性结肠炎患者ESR（β=1.316,P=0.000）和CRP（β=1.233,P=0.015）的线性相关因子;血小板（β=0.436,P=0.037）和凝血酶原时间（β=0.810,P=0.000）是女性克罗恩病患者克罗恩病活动指数的线性相关因子。结论炎症性肠病患者凝血和纤溶状态异常和疾病活动性相关,纤维蛋白原、血小板和凝血酶原时间是炎症活动性的预测因素。

Influence of altered coagulation and fibrinolysis status on disease activity of inflammatory bowel disease

Objectives To evaluate altered coagulation and fibrinolysis status, and to analysis factors associated with disease activity in active patients with inflammatory bowel disease. Methods A cohort of 271 consecutive patients with active IBD was compared with healthy controls for coagulation and fibrinolysis status. Analyses were done to elucidate the associations between altered coagulation and fibrinolysis status stratified by gender and inflammatory parameters. Results The mean levels of platclet, platelet distribution width, prothrombin time, fibrinogon, activated partial thromboplastin time were significantly higher in male or female patients with Crohn＇s disease （CD） or ulcerative colitis （UC） than that in controls （ all P 〈 0.05 ）, whereas mean platelet volume was lower （P 〈 0.01 ）. Furthermore, linear regression indicated that fibrinogen was an independent predictor of ESR （ β = 1. 316, P =0. 000） and CRP （ β = 1. 233, P = 0. 015） in male patients with active UC. And Crohn＇ s Disease Activity Index was predicted by platelet （β =0.436, P = 0. 037） and prothrombin time （ β = 0. 810, P = 0. 000） in female patients with CD. Conclusion It is suggested that in IBD patients, abnormalities in coagulation and fibrinolysis status were associated with disease activity. Fibrinogen, platelet and prothrombin time were predictors of inflammatory parameters.