活动期溃疡性结肠炎患者体内血小板激活状态的评价

Assessment of platelet activation in active ulcerative colitis.

目的 探讨血小板激活和活动期溃疡性结肠炎的关系。方法 对 32例活动期溃疡性结肠炎、11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 2 7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 4 3例溃疡性结肠炎内镜下表现和结肠黏膜活检情况。结果 32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 .0 1) ;32例活动期溃疡性结肠炎P 选择素和TXB2 明显高于IBS组和正常对照组 ,差异有显著性 (P <0 .0 1和P <0 .0 5 )。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。

Objective To determine whether platelet activation is associated with active ulcerative colitis (UC). Methods Platelet aggregability was assessed by means of SH 93 intelligent blood aggregation and coagulation tester; P selectin and thromboxane B 2 (TXB 2) 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 43 patients with UC. Results Increased circulating platelet aggregability was detected in active ulcerative colitis compared with IBS and healthy controls ( P < 0.01 ). Increased P selectin and TXB 2 were detected in active ulcerative colitis compared with IBS and healthy controls ( P <0.05 and P <0.01 respectively). P selectin was also increased in inactive UC. Conclusions Active ulcerative colitis is marked by increased platelet activation. Platelet may directly contribute to the acute inflammation of colon mucosa. Increased platelet aggregation and TXB 2 may be related to the degree of disease activity; P selectin is specific to UC. Therefore, antiplatelet agents may be valuble in the management of UC.