复发性阿弗他溃疡患者止凝血系统的检测及意义

Detection of coagulation and hemostasis and its significance in patients with recurrent aphthous ulcer

目的探讨复发性阿弗他溃疡(RAU)患者凝血、抗凝及纤溶指标的变化及临床意义。方法选取RAU患者58例,分为轻型阿弗他溃疡(MiAU)组、重型阿弗他溃疡(MjAU)组及疱疹样阿弗他溃疡(HU)组,以50例健康成人为对照组,采用ACL-200型全自动凝血分析仪、酶联免疫吸附(ELISA)法检测血浆凝血因子VⅢ活性(FVⅢ:C)、蛋白C抗原(PC:Ag)、总蛋白S抗原(TPS:Ag)、组织型纤溶酶原激活物抗原(t-PA:Ag)、纤溶酶原激活剂抑制物-1抗原(PAI-1:Ag)、D-二聚体(D-Dimer)含量。结果 RAU患者PC:Ag、TPS:Ag、PAI-1:Ag、D-Dimer含量均高于对照组(P均<0.01),t-PA:Ag明显低于对照组(P<0.01)。MjAU组PC:Ag低于MiAU组(P<0.05);MiAU组FVⅢ:C显著高于对照组(P<0.01),而MjAU组FVⅢ:C虽高于对照组,但差异无统计学意义(P>0.05)。结论 RAU患者体内存在凝血、抗凝及纤溶系统异常,而FVⅢ:C、PC:Ag水平与疾病的严重程度有关。

Objective To investigate the changes of coagulant and hemostatic parameters in patients with recurrent aphthous ulcer（RAU）.Methods 58 patients with RAU and 50 healthy controls were recruited into the study.RAU patients were classified into three groups：the minor aphthous ulcers（MiAU）group,the major aphthous ulcers（MjAU）group and the herpetiform ulcers（HU）group.Factor VⅢ clotting activity（FVⅢ：C）,protein C antigen（PC：Ag）,total protein S antigen（TPS：Ag）,tissue-type plasminogen activator antigen（t-PA：Ag）,plasminogen activator inhibitor-1 antigen（PAI-1：Ag）and D-dimer were detected by ELISA or by ACL-200 full automatic coagulation analyzer.Results PC：Ag,TPS：Ag,PAI-1：Ag and D-Dimer content were significantly higher in RAU patients than in the controls（P〈0.01）.The level of t-PA：Ag was significantly decreased in patients with RAU（P〈0.01）.PC：Ag was lower in the MjAU group than in the MiAU group（P〈0.05）.The lever of FVⅢ：C was significantly increased in MiAU patients compared with the controls（P〈0.01）,while no statistical significance was observed between MjAU patients and the controls（P〉0.05）.Conclusion There were coagulant,anticoagulant and fibrinolytic abnormalities in patients with RAU,and the changes of FVⅢ：C and PC：Ag were correlated with the severity of RAU.