Correlation Between Ulcerative Colitis And Coagulation Function

ObjectiveTo explore the changes of coagulation function in patients with active ulcerative colitis(UC)and its correlation with the severity of intestinal inflammation as well as related indicators as the value of judging the activity of UC disease,so as to increase the understanding of UC,and provide reference for the diagnosis and treatment of UC.MethodSelecting 175 patients with active UC who were hospitalized in Hospital of dalian medical university from January 2016 to December 2020 as the UC group,including 97males(55.43%)and 78 females(44.57%).The male/female ratio is 1.24:1,the average age is 47.66±14.41 years old,and they were divided into groups of 20-40 years old,41-60 years old,and >60 years old,All patients had completed fiber colonoscopy,and the diagnosis was in line with “the Consensus on Diagnosis and Treatment of Inflammatory Bowel Disease(2018 · Beijing)”,and the Mayo score was >2.At the same time,the UC group was divided into three groups of mild,moderate and severe according to the modified Truelove and Witts inflammation grading criteria.And 88 Patients with normal colonoscopy from the Hospital of dalian medical university were selected as the control group.Collecting the indexes of coagulation and inflammation including platelet(PLT),mean platelet volume(MPV),platelet distribution width(PDW),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin activity(PTA),international standard ratio(INR),fibrinogen(FIB),D-dimer(DD),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP).Comparing and analyzing the changes of these indexes between UC group and control group and among subgroups of UC group,analyzing the correlation between blood coagulation indexes and disease activity index,ESR and CRP.The data were analyzed by statistical software SPSS26.0.The metrological data were expressed by median and quartile spacing M(P25 < P75).Different statistical methods were used according to whether the data were in accordance with the normal distribution.and analyzing the correlation between data inspection,r < 0 OR r > 0 were considered correlative.P < 0.05 was considered statistically significant,P < 0.01 was considered more statistically significant.Results1.Comparison of various indicators between UC group and control group: PLT,PCT,PT,APTT,INR,FIB,DD,ESR,CRP in UC group were significantly higher than those in control group(P < 0.01);MPV,PDW and PTA were significantly lower than those in the control group(P < 0.01),TT was not statistically significant(P > 0.05).2.Comparison of various indicators of different severity groups of UC: There were statistical difference among patients with different severity of UC in PLT、MPV、PDW、PCT、PT、TT、INR、PTA、FIB、DD、ESR、CRP(P < 0.05).PLT,PCT,PT,INR,FIB,DD,ESR,CRP in severe UC group were higher than those in mild group(P < 0.05),while MPV,PDW,TT and PTA were lower in severe group than those in mild group(P< 0.05);PT,INR,FIB,DD,ESR,CRP in severe UC group were higher than those in moderate group(P < 0.05),while MPV,PDW,PTA were lower in severe UC group than those in moderate group(P < 0.05).PLT,PCT,TT were not statistically significant(P >0.05)between severe group and moderate group;PLT,PCT,FIB,DD,ESR,CRP in moderate group were higher than those in mild group(P < 0.05),while TT,PTA were lower in moderate group than those in mild group(P < 0.05).MPV,PDW,PT,INR were not statistically significant(P > 0.05)between moderate group and mild group;APTT was not statistically significant among severe group,moderate group and mild group(P=0.114 > 0.05).3.Comparison of various indexes among different age groups of UC patients: PLT,PCT,PT,APTT,INR and PTA were significantly different in different age groups(P <0.05).PLT and PCT in 20-40 years old group were significantly higher than those in >60 years old group(P < 0.05).PCT,PT,APTT and INR in 20-40 years old group were higher than those in 41-60 years old group(P < 0.05),while PTA was lower in 20-40 years old group than in 41-60 years old group(P < 0.05).There were no significant difference in PDW,MPV,TT,FIB,ESR,DD and CRP(P > 0.05).4.Comparison of various indicators among patients with UC of different genders:TT was statistically different between male and female(P=0.007 < 0.01),while PLT,PCT,PDW,MPV,PT,APTT,INR,PTA,FIB,DD,TC,ESR and CRP were not statistically different between male and female(P > 0.05).5.Correlation analysis of coagulation-related indexes and disease activity index,ESR,CRP in UC group: PLT,PDW,MPV,PCT,PT,TT,INR,PTA,FIB,DD were significantly related to disease activity index,ESR,CRP(|r| > 0,P < 0.01),PLT,PCT,PT,INR,FIB,DD were positively correlated with the disease activity index,ESR and CRP(P < 0.01),PDW,MPV,TT,PTA were negatively correlated with disease activity index,ESR and CRP(P < 0.01),APTT has no statistical significance in correlation analysis with disease activity index,ESR,and CRP(P > 0.05).Conclusion1.There are abnormalities of platelet,coagulation and fibrinolysis system in patients with UC,which is characterized by the increase of PLT,PCT,PT,APTT,INR,FIB,DD and the decrease of PDW,MPV and PTA,indicating that hypercoagulation state exists in patients with UC.2.PLT,PDW,MPV,PT,PTA,FIB and DD can be used as indicators to evaluate the degree of disease activity and inflammation.These indicators are of great value for monitoring HCS and provide reference for the diagnosis and treatment of UC.