The Clinical Significance Of Platelet And Coagulation Function In Patients With Inflammatory Bowel Disease

Background In recent years,the incidence of inflammatory bowel disease(IBD)in China is increasing year by year.Studies have shown that the peripheral blood of IBD patients is hypercoagulable,and intestinal microcirculation dysfunction can lead to microthrombosis,leading to intestinal mucosal ischemia and necrosis,and ulcer formation,and further aggravate the condition.Objective This study retrospectively analyzed the platelet-related parameters and coagulation function indexes in IBD patients,in order to explore the changes of platelet and coagulation indexes in IBD patients and their relationship with disease activity.Method1.From September 2016 to December 2018,48 patients with ulcerative colitis and 44 patients with Crohn’s disease hospitalized in our hospital were selected as the study subjects.Forty-eight healthy persons who underwent physical examination in our hospital during the same period were selected as healthy control group.2.The platelet-related parameters and coagulation function indexes including platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),Prothrombin time(PT),Activated partial thromboplastin time(APTT),Thrombin time(TT),Fibrinogen(FIB),D-dimer.The MPV/PLT and PDW/PLT ratios of each subject were also calculated.3.The data was analysed by statistical software.Results1 Comparison of platelet parameters and coagulation parameters between UC and CD group and control group:PLT were significantly higher in UC group and CD group at active stage than that in healthy control group(P < 0.05).Similarly,the level of PDW in the UC and CD group were also significantly higher than that in the control group(P < 0.05).But the MPV level of the patients was lower than that in the healthy controls,but there were no significant difference in statistics(P > 0.05).Compared with the control group,MPV / PLT in IBD patients was significantly lower(P < 0.05).In addition,in comparison with coagulation indexes,compared with the control group,the D-dimers level of UC and CD patients were significantly higher than that of healthy controls(P < 0.05).Although PT and FIB increased in IBDpatients than that in the control group,there was no significant difference(P > 0.05).2 Comparison of platelet parameters and coagulation parameters between UC and CD patients with different conditions:In UC and CD patients,the PLT level of severe patients was significantly higher than that of moderate patients and mild patients,and the PLT level of moderate patients was significantly higher than that of mild patients(all P < 0.05).Compared with MPV,the MPV level of severe patients was significantly lower than that of moderate patients and mild patients(all P < 0.05).And MPV/PLT of UC and CD patients with severe illness were significantly lower than those of moderate illness and mild illness,while MPV/PLT ratio of moderate illness patients was significantly lower than that of mild illness patients(all P < 0.05).In addition,even mild illness patients,their MPV/PLT ratio was still significantly lower than that of healthy controls(P < 0.05).In comparison,with the increase of the severity of the disease,PT was significantly prolonged,FIB and D-dimers levels were also significantly increased(P < 0.05),but the increase of D-dimers is more significant.3 Correlation analysis of platelet parameters and coagulation parameters with disease activity in UC and CD patients:UC-AI were positively correlated with PLT,PDW,FIB and D-dimer(all P < 0.05).The correlation index of UC-AI with PLT and D-dimer were r=0.387 and 0.352,respectively.However,UC-AI has a weak negative correlation with MPV(r=-0.215),and has a strong negative correlation with MPV/PLT,with R value as high as-0.658.PLT,FIB and D-dimers were also positively correlated with CD-AI(all P < 0.05).The correlation index between PLT and CD-AI was the highest(0.401),while MPV was negatively correlated with CDAI,but the R value was-0.209,which was weak.However,CD-AI was negatively correlated with MPV/PLT also,but the R value was as high as-0.701.Conclusions:1 The coagulation function of IBD patients is abnormal when their condition is in active stage,which is manifested by elevated PLT and PDW and D-dimer,decreased MPV/ PLT,suggesting that the body is in hypercoagulable state.2 PLT,FIB,D-dimers are positively correlated with disease activity index,MPV/ PLT is negatively correlated with disease activity index.They may be used as reference indicators for judging disease activity of IBD.