炎症性肠病凝血功能变化的相关分析

发布时间：2018-07-04 10:48

本文选题：炎症性肠病 + 克罗恩病　；参考：《浙江大学》2017年硕士论文

【摘要】：背景与目的:血栓栓塞事件作为炎症性肠病(inflammatory bowel disease,IBD)的肠外表现之一受到了越来越多的关注,这与IBD患者外周血处于高凝状态有关,本次研究目的在于分析IBD患者体内各项凝血相关指标的变化,并探索其与疾病活动度的关系,为评估和预测疾病活动情况及预防性抗凝治疗提供更充足的依据。方法:选取2016年1月至2016年12月于浙江大学医学院附属邵逸夫医院确诊为CD及UC的住院患者共317名为病例组,选取同时段浙江大学医学院附属邵逸夫医院健康体检者100名作为对照组,比较病例组与对照组凝血酶原时间(PT)、凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FG)、D-二聚体(D-Di)、血小板计数(PLT)、平均血小板体积(MPV)的差异以及疾病不同严重程度上述各项指标的差异,对凝血相关指标与疾病活动指数、血沉(ESR)、超敏C反应蛋白(CRP)进行Spearman相关性分析及多元线性回归分析。结果:IBD 组患者较对照组 PT、APTT、FBG、D-Di、PLT 显著升高(P0.01),TT、MPV显著降低(P0.01),PTA无明显差异(P0.05)。UC组患者D-Di显著高于CD组(P0.05),而CD组PLT显著高于UC组,MPV显著低于UC组(P0.05)。活动期患者凝血指标异常更为显著,不同严重程度患者之间部分凝血相关指标存在差异,中重度活动期差异更明显。PT、PTA、APTT、PLT、MPV与疾病活动程度存在一定相关性,但相关关系均较弱,FBG与ESR、CRP呈显著线性正相关关系,可作为一个评估和预测IBD炎症进展程度的较好指标。结论:IBD患者外周血凝血相关指标存在显著异常,表现为PT、APTT、FBG、D-Di、PLT升高,TT、MPV降低,这些凝血指标异常与疾病活动度存在一定相关性,其中FBG与疾病活动度呈显著线性正相关,可作为一个评估和预测IBD炎症进展程度的较好指标。
[Abstract]:Background and objective: thromboembolic events, as one of the external manifestations of inflammatory bowel disease (IBD), are becoming more and more concerned. This is related to the hypercoagulability of peripheral blood in IBD patients. The purpose of this study is to analyze the changes in the related indexes of coagulation and blood in the patients with IBD and to explore the degree of activity and the degree of activity of the disease. To provide a more sufficient basis for evaluating and predicting disease activity and preventive anticoagulant therapy. Methods: a total of 317 hospitalized patients who were diagnosed as CD and UC in Sir Run Run Shaw Hospital of Zhejiang University Medical College from January 2016 to December 2016 were selected as the case group, and the healthy body affiliated to the affiliated Hospital of Zhejiang University was selected. 100 subjects were compared with the control group, compared with the prothrombin time (PT), prothrombin activity (PTA), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FG), D- two polymer (D-Di), platelet count (PLT), average platelet volume (MPV), and the various severity of the disease. Spearman correlation analysis and multiple linear regression analysis were carried out on coagulation related indexes and disease activity index, ESR, and hypersensitivity C reactive protein (CRP). Results: the patients in IBD group were significantly higher than the control group PT, APTT, FBG, D-Di, PLT significantly increased (P0.01). Group CD was higher than group CD (P0.05), and PLT in group CD was significantly higher than that in group UC, MPV was significantly lower than that in group UC (P0.05). There was a significant linear correlation between FBG and ESR and CRP, which can be used as a good index to evaluate and predict the progression of IBD inflammation. Conclusion: there are significant abnormalities in the peripheral blood coagulation related indexes in IBD patients, which are PT, APTT, FBG, D-Di, PLT, TT, and lower MPV, and these abnormal coagulation indexes are related to the degree of disease activity. FBG has a significant positive correlation with disease activity, and can be used as a good indicator to evaluate and predict the progression of IBD inflammation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574

【相似文献】