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

The levels of molecular markers of prethrombotic state in patients with ulcerative colitis and its significance

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。

Objective To explore the changes of markers of coagulation,anticoagulation and fibrinolysis,and relation ship to clinical activity and extent of ulcerative colitis（ UC）. Methods The plasma levels of granular membrane protein - 140 （ GMP - 140）, Yon Willbrand factor antigen （ vWF ： Ag）, thrombomodulin （ TM ）, D - Dimer（DD） in 32 patients with active UC, 20 patients with remissive UC and 45 controls were measured by enzyme linked immunosorbant assays （ELISA）. Anti -thrombomodulin Ⅲ activity （AT -Ⅲ：A）was determined by chromogenic substrate method. Results The concentrations of GMP - 140, vWF ： Ag, TM, DD were significantly increased in patients with active UC compared with patients with remissive UC and healthy controls. Compared with healthy controls, these indexes in patients with remissive UC also increased significantly. Mean while, the level of AT-Ⅲ ： A was significantly decreased in patients with active UC compared with patients with remissive UC and healthy controls. The plasma levels of these indexes were significantly different between different distributions in patients with active UC. There were significant correlations between the molecular markers of prethrombotic state. Conclusion The results suggested that there was an obvious prethrombotic state in patients with UC. The levels of GMP- 140, vWF： Ag,TM, DD ,AT- Ⅲ： A were correlated with activity and severity of UC. Persistent hypercoagulation may contribute to the clinical course of ulcerative colitis.