| Ulcerative colitis(UC)is a chronic and non-specific inflammatory disease,Its etiology and pathogenesis is not yet clear,the main clinical manifestations consist of recurrent abdominal pain,diarrhea and bloody mucopurulent stool.In recent years,the study found that the patients with UC is frequently in a hypercoagulable state,it concurrent thromboembolic disease easily,and more of asymptomatic blood clots,there is a potential threat for the patients with UC,the complication of thromboembolism has become a leading cause of death in patients with ulcerative colitis,attracting more and more attention.The pathogenesis of thromboembolism in IBD is very complex,and not yet clear,Most studies find that IBD hypercoagulable state,thromboembolism development achieved through its effects on blood coagulation mechanism,Most studies have found that hypercoagulable state and the development of thromboembolism in UC by affecting the coagulation mechanism,and that is the result of the interaction between the acquired and the genetic risk factors.The coagulation disorders in patients with UC including platelets dysfunction,endotheliocyte damage,abnormal coagulation system and fibrinolysis system damage and the immune system dysfunction,The changes of these related risk factors have taken place in advance of the thrombosis.Therefore,monitoring the related coagulation indicators effectively in patients with UC,strengthen the management of hospitalized patients or patients with thrombotic risk,it could improve the hypercoagulable state in patients with UC,prevent thromboembolism,reduce their mortality,improve the quality of life in patients with UC and provide new clinical and research directions for the treatment of UC.The role of related coagulation indicators in the pathogenesis of UC and in the risk of thromboembolism is not yet clear.Needing further study to clarify.The experimental study in patients with UC on the changes of platelet count and mean platelet volume,p-selectin expression,homocysteine,blood coagulation factor Ⅴ,blood coagulation factor Ⅷ,d-dimer and anticardiolipin antibody level.Objective: To detect the changes of coagulation indicators in patients with UC and to see whether it is correlation with the hypercoagulable state and the severity of UC.Methods:1 From January 2016 to January 2017 in the Second Hospital of Hebei Medical University,29 patients with UC were accepted as the experimental group.They were divided into three groups according to modified Mayo disease activity index: mild,moderate and severe,mild contains 10 cases,moderate contains 7 cases,severe contains 12 cases.11 patients with colonic polyps were accepted as control group.2 To detect the experimental group and the control group in peripheral blood platelet count,average volume of platelets and p-selectin expression,homocysteine,blood coagulation factor Ⅴ,blood coagulation factor Ⅷ,d-dimer,anticardiolipin antibody levels.Use the SPSS13.0,in the method of the analysis of variance(ANOVA)to analyze the dates.3 Collect 2 pieces of colonic mucosal at rectum-sigmoid junction under colonoscope.Observe the histopathology of colonic mucosa with HE staining.Detecting the expression of P-selectin by immunohistochemistry.Use the SPSS13.0,in the method of the chi-square to analyze the dates.Results:1 The results of peripheral bloodPLT count,P-selectin,homocysteine,blood coagulation factor Ⅷ and d-dimer in UC patients is significantly higher than the control group(P <0.05),the differences are statistically significant;MPV,blood coagulation factor Ⅴ is significantly lower than the control group(P <0.05),the differences are statistically significant;Positive rate of ACA are significantly higher than control group.PLT counts showed severe > moderate > mild > control,comparison of any two group show that P <0.05,the differences are statistically significant;Homocysteine show that severe group is significantly higher than mild and moderate group(P <0.05);Blood coagulation factor VIII show that severe group is significantly higher than mild group(P <0.05);D-dimer show that severe and moderate group is significantly higher than mild group(P<0.05);P-selectin,MPV,blood coagulation factor Ⅴ,comparison of any two group show that P >0.05,the differences are not statistically significant;2 HE stainingThe structure of colonic mucosal epithelial is integrity in control group,glandular cells arranged neatly,more goblet cells and a small amount of inflammatory cell infiltration.mucosal epithelium fall off or missing in UC group and a number of inflammatory cell infiltration,the glands is deformation,disordered arrangement and the number is reducing.Crypt structure is disorder,in the crypts and crypt epithelium observed a large number of neutrophil infiltration,goblet cells are decreased;3 The expression of P-selectin in colonic mucosa by immunohistochemistry stainingThe p-selectin expression in colonic mucosa of patients with UC are significantly increased compared with the control group,the differences are statistically significant(P <0.05),P-selectin positive staining rates show that severe 83.33%(10/12)> moderate 57.14%(4/7)>mild 30%(3/10),comparison of any two group show that P < 0.05,the differences are statistically significant.Conclusion:1 The patients with UC is in a hypercoagulable state,with blood coagulation disorders,It is mainly related to platelets dysfunction,endotheliocyte damage,abnormal coagulation system and fibrinolysis system damage and the immune system dysfunction.2 PLT count,p-selectin,homocysteine,blood coagulation factor VIII and d-dimer in patients with UC are significantly higher than the control group,blood coagulation factorⅤ,MPV are significantly lower than the control group,the positive rate of ACA is significantly higher than the control group,These factors playing an important role in monitoring the body of hypercoagulable state,are effective indicators in preventing thrombosis in clinical.3 PLT count and p-selectin expression in colonic mucosal are associated with the severity of UC. |
PDF Full Text Request