血小板激活与活动期发生溃疡性结肠炎的关系

Study of platelet activation in active ulcerative colitis

目的探讨活动期溃疡性结肠炎和血小板激活状态的关系。方法对33例活动期溃疡性结肠炎、12例缓解期溃疡性结肠炎、30例肠易激综合征(IBS)患者和正常对照组28例用SH-93智能血液凝聚仪检测血小板聚集率,用酶联免疫法检测P选择素和血栓素B2(TXB2)。同时评价45例溃疡性结肠炎内镜下表现和结肠黏膜活检情况。结果33例活动期溃疡性结肠炎患者平均1min血小板聚集率和最大血小板聚集率均明显高于IBS组和正常对照组(P<0·01),33例活动溃疡性结肠炎P选择素和TXB2明显高于IBS组和正常对照组,差异有显著意义(P<0·01或P<0·05)。缓解期溃疡性结肠炎的P选择素也高于正常对照组。结论活动期溃疡性结肠炎患者体内存在血小板激活,血小板可能直接参与结肠黏膜的急性炎症反应。其中P选择素是溃疡性结肠炎的特异性指标,而血小板聚集率和TXB2与疾病的活动度有关。抗血小板药物可能对溃疡性结肠炎有一定的治疗效果。

Objective To determine whether platelet activation is associated with active ulcerative colius （UC）. Methods Platelet aggregability was assessed by means of SH-93 intelligent blood aggregation and coatgulation tester; P-selectin and thromboxane B2 （TXB2） were detected by means of ELISA method in patients with UC as well as in controls, including healthy volunteers and patients with irritable bowel syndrome（IBS）. Colonoscopy and biopsy were performed in 45 patients with UC. Results Increased circulating platelet aggregability was detected in active colitis ulcerative colitis compared with IBS and healthy controls（ P 〈 0.01 ）. Increased P-selectin and TXB2 were detected in active ulcerative compared with IBS and healthy controls（ P 〈 0.05 or P 〈 0.01, respectively）. Pselectin was also increased in inactive UC. Conclusion Active ulcerative colitis is marked by increased platelet activation. Platelet may direcily contribute to the acute inflamma.tion of colon mucosa. Increased platelet aggregation and TXB2 may be related to the degree of disease activity; P-selectin is specific to UC. Therefore,antiplatelet agents may be valuble in the manage, ent of. UC.