克罗恩病凝血功能变化的研究

发布时间：2018-06-02 00:04

本文选题：克罗恩病 + 凝血功能　；参考：《南京大学》2014年硕士论文

【摘要】：研究目的：观察克罗恩病(CD)患者凝血功能改变情况,讨论影响患者凝血功能的风险因素。研究方法：将2013年6月至2013年12月期间我科就诊CD患者作为研究对象,同时期健康志愿者作为对照组纳入本研究,分别监测以下指标：炎症活动性指标(hs-CRP, ESR, CDAI评分),血常规、常规凝血检查,血栓弹力图(TEG)检查。按CDAI评分对患者进行分组：A组(活动期),A1组(中重度活动期),B组(缓解期),C组(健康对照),比较各组间凝血功能变化情况,并分析引起凝血功能改变的风险因素。研究结果：入组病人共277例,其中活动期87例,缓解期87例,健康对照103例。CD患者与健康对照组凝血四项指标无明显差异(p0.05),TEG参数R值、K值无明显差异(p0.05),MA值、α值显著增高(p0.05)；活动期CD患者较缓解期、健康组MA值、α值显著增高(p0.05),R值、K值无明显差异(p0.05)；缓解期CD患者R值、K值、MA值无显著差异(p0.05),α值增高(p0.05)；中重度活动期CD患者较健康对照组R值、K值显著降低(p0.05),较其余组MA值、α值显著增高(p0.05)；各组间LY30、EPL值无显著性差异(p0.05)。多元线性回归分析发现CDAI、CRP、PLT与MA值呈正相关(r=0.463,p0.05),CDAI与α值呈正相关(r=0.323,p0.05)。研究结论：CD患者存在凝血功能亢进,主要表现为血小板型高凝,凝血因子活性、纤溶系统无明显改变。缓解期CD患者凝血功能无明显异常,活动期CD患者存在明显的血小板型高凝状态,中重度活动CD患者同时存在凝血因子高活性及血小板功能亢进。CDAI评分及CRP可以作为预测CD患者发生凝血功能障碍的指标。对于CD患者凝血功能的诊断,TEG检查相较于凝血四项检查更为敏感。
[Abstract]:Objective: to observe the changes of coagulation function in patients with Crohn's disease (CD) and discuss the risk factors. Methods: from June 2013 to December 2013, CD patients in our department and healthy volunteers in the same period as control group were included in the study. The following indexes were monitored: inflammatory activity index, ESRs, CDAI score, and blood routine examination. Routine coagulation and thromboelastography (TEG) were performed. According to the CDAI score, the patients were divided into two groups: group A (active phase A group) (moderate and severe active stage group B group (remission stage group C group), healthy control group). The changes of coagulation function among groups were compared, and the risk factors of coagulation function change were analyzed. Results: a total of 277 patients were included in the study, including 87 active and 87 remission. There was no significant difference in the four indexes of coagulation between the healthy control group (103 cases) and the healthy control group (P < 0.05). There was no significant difference in the R value and K value of the TEG parameter between the healthy control group and the healthy control group. In the healthy group, the 伪 value was significantly higher than that in the healthy control group. There was no significant difference in the value of K and K between the two groups, but there was no significant difference in the value of K and K in the patients with CD in remission stage. The increase of 伪 value was p0.05A; the value of K in patients with moderate and severe active CD was significantly lower than that in the healthy control group, which was significantly lower than that in the rest of the control group. The MA value and 伪 value of the group were significantly higher than those of the control group (p 0.05), but there was no significant difference in the EPL values of LY30 and LY30 among the groups (P 0.05). Multiple linear regression analysis showed that there was a positive correlation between the level of CRPPLT and MA value in CDAII, and the correlation between CDAI and 伪 value was positive correlation between CDAI and 伪 value. Conclusion there is hypercoagulant function in the patients with 1: CD, mainly manifested as platelet type hypercoagulability, coagulation factor activity, and fibrinolytic system. There was no obvious abnormality of coagulation function in patients with CD in remission stage, but there was obvious platelet hypercoagulability in patients with active CD. The high activity of coagulation factor and platelet hyperfunction. CDAI score and CRP can be used as predictors of coagulation dysfunction in patients with moderate and severe active CD. The diagnosis of coagulation function in CD patients was more sensitive to TEG than to the four tests of coagulation.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574.62

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