炎症性肠炎中蛋白C系统的抗炎和抗凝的分析

Anti-inflammatory and anticoagulant properties of the protein C system in inflammatory bowel disease

目的:评价蛋白C(protein C,PC)系统与炎症性肠炎(inflammatory bowel disease,IBD)的相关性。方法:选取我院48例溃疡性结肠炎患者ulcerative colitis(UC)、42例克罗恩患者Crohn's disease(CD)和35例健康对照,检测蛋白C、蛋白S(protein S,PS)和可溶性血栓调节蛋白(soluble thrombomodulin,sTM),分析蛋白C系统和疾病活动性、血栓变量和炎性标志物的相关性。结果:UC患者比正常人的sTM明显升高(22.12,16.06 ng/ml,P<0.05).IBD的PC高,PS低(P<0.05)。IBD的肿瘤坏死因子(Tumor necrosis factorα,TNF-α)增高,白细胞介素6(interleukin 6,IL-6)只在CD中增高。在UC患者中,sTM与PC、PS正相关(r=0.25、r=0.323,P<0.05)。UC患者PC与活动期正相关(r=0.321,P<0.05)。TNF-α,IL-6,,CRP与PC,PS和sTM无相关性。结论:CD和UC患者蛋白C系统缺乏,IBD的高凝状态不仅与炎症相关,也与抗凝的紊乱有关。

Objective： To evaluate the correlation between protein C system and inflammatory bowel disease.Methods： The levels of PC,free protein S（PS） and soluble thrombomodulin（sTM） were measured in 48 consecutive patients with ulcerative colitis（UC）,42 patients with Crohn′s disease（CD） and 35 healthy volunteers.Correlations between PC system components and disease activity,hemostatic variables and inflammatory markers were assessed.Results： sTM levels in patiens with UC were higher compared with controls（22.12,16.06 ng/ml;P0.05）.In patients with IBD,PC activity was higher and PS activity was lower compared with controls（P0.05）.Tumor necrosis factor α（TNF-α） levels were higher in patients with IBD,and interleukin 6（IL-6） levels were higher only in patients with CD.In patients with UC,a positive correlation was observed between sTM and both PC and PS levels（r=0.25,r=0.323,P0.05）.Only PC levels correlated with UC activity（r=0.321,P0.05）.No correlations of TNF-α,IL-6 and C-reactive protein with PC,PS and sTM levels were observed.Conclusion： The PC pathway is defective in patients with CD and UC.Hypercoagulability in IBD might be associated not only with the inflammatory process but also disturbances in the anticoagulant system.