慢性荨麻疹患者血浆D二聚体、活化凝血因子Ⅶ及活化凝血因子Ⅻ水平的研究

Levels of plasma D-dimer, activated coagulation factor Ⅶ and Ⅻ in patients with chronic urticaria

目的 探讨血浆D二聚体、活化凝血因子Ⅶ（FⅦa）及活化凝血因子Ⅻ（FⅫa）在慢性荨麻疹（CU）患者中的表达及其与CU发病的关系.方法 对50例CU患者及50例健康对照用干式免疫散射色谱法检测血浆D二聚体水平,用酶联免疫吸附法检测FⅦa及FⅫa的水平,并结合患者病情严重程度情况进行分析.对43例CU患者自体血浆皮肤试验（APST）及41例CU患者作自体血清皮肤试验（ASST）结果与其血浆D二聚体水平进行比较.结果 CU患者血浆中D二聚体及FⅦa的水平均明显高于健康对照组（P＜0.05）,前者升高水平与病情严重程度呈正相关（P＜0.05）;CU患者FⅫa水平与健康对照组比较,差异无统计学意义（P＞0.05）.APST（＋）患者的D二聚体水平明显高于APST（-）患者（P＜0.05）,而ASST（＋）患者D二聚体水平与ASST（-）患者比较,差异无统计学意义（P＞0.05）.结论 凝血机制与CU相关,外源性凝血途径起着作用,针对凝血机制的研究对于CU的病情评估和临床治疗具有一定的意义.

Objective To measure the levels of plasma D-dimer,activated coagulation factor Ⅶ （FⅦa） and activated clotting factor Ⅻ （FⅫa） in patients with chronic urticaria （CU）,and to investigate their relationship with the occurrence of CU.Methods Venous blood samples were collected from 50 patients with CU and 50 healthy human controls.Dry-column immune scattering chromatography was performed to detect the plasma level of D-dimer,and enzyme-linked immunosorbent assay （ELISA） to measure the levels of FⅦa and FⅫa.In addition,autologous plasma skin test （APST） was conducted in 43 patients with CU,and autologous serum skin test （ASST） in 41 patients with CU.A correlation analysis was carried out between the above three parameters and disease severity as well as between the results of APST and ASST and plasma level of D-dimer.Results The levels of plasma D-dimer and F Ⅶa were significantly higher in patients with CU than in healthy human controls （both P 〈 0.05）,while no significant difference was found in FⅫa level between the two groups （P 〉 0.05）.Moreover,the degree of increase in D-dimer plasma level was positively correlated with disease severity in the patients with CU.The plasma level of D-dimer was significantly higher in APST-positive patients than in APST-negative patients （P 〈 0.05）,but not significantly different between ASST-positive and-negative patients （P 〉 0.05）.Conclusions Coagulation mechanism,especially the extrinsic coagulation pathway,is related to the occurrence of CU.Studies on coagulation mechanism are beneficial to the evaluation of severity,and clinical treatment,of CU.