Study On The Relationship Between Coagulation Function And Disease Activity Index And Hypercoagulable State In Patients With Ulcerative Colitis

Objective:To investigate the value of common coagulation indicators,thromboelastography(TEG)and thrombus molecular markers in assessing the disease activity and blood hypercoagulation in patients with ulcerative colitis(UC).Methods:25 patients with UC(UC group)and 34 patients without IBD(NIBD group)who were hospitalized in our hospital from March 2015 to July 2016 were enrolled in this study.Patients with UC were graded according to the severity of the disease.The common coagulation indicators,TEG and thrombus molecular markers were examined to test the differences between UC group and NIBD group and between different disease activity groups of UC,and to analyze the correlation with disease activity index.Results:As shown in the results of conventional coagulation test,prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio(INR),fibrinogen(FIB)and platelet(PLT)in UC group were significantly higher while thrombin time(TT)was statistically lower than those in NIBD group(P<0.05),and only PLT was significantly increased with the aggravation of disease(P<0.05).The results of TEG showed that compared with those in NIBD group,a angle,maximum amplitude(MA)and LY30 were increased while response time(R)and kinetics(K)were decreased in UC group(P<0.01).All of the TEG indexes were statistically different among the there groups with different disease activity(P<0.05).In the moderate group,K was significantly lower than that in the mild group,and a Angle was significantly higher than that of the mild group(P<0.05).R and K of the severe group were significantly lower while a angle,MA and LY30 were higher than those of the mild group and the moderate group respectively(P<0.05).As shown in the results of thrombus molecular markers,compared with those in NIBD group,fibrinogen degradation product(FDP),D-dimer(D-D)and Von Willebrand factor(vWF)were increased while antithrombin Ⅲ(AT-Ⅲ),protein C(PC)activity and protein S(PS)activity were decreased in UC group(P<0.05).FDP,D-D,PC activity,PS activity and vWF were significantly different among the three groups with different disease severity(P<0.05).In the moderate group,PS activity was significantly lower than that in the mild group(P<0.05).FDP and D-D of the severe group were significantly higher while PC activity was lower than those of the mild group and the moderate group(P<0.05).There was a significantly increase of vWF and a significantly decrease of PS activity in the severe group than in the mild group(P<0.05).The correlation analysis showed that only the level of PLT in the conventional coagulation indexes was positively correlated with disease activity(P<0.01).In the TEG index,the levels of angle a,MA and LY30 were positively correlated with the disease activity(P<0.01),and the levels of R and K were negatively correlated with the disease activity(P<0.01).In the thrombus molecular marker indexes,the levels of FDP,DD and vWF were positively correlated with disease activity(P<0.01),and the levels of AT-III,PC activity and PS activity were negatively correlated with disease activity(P<0.05).Conclusion:1.Patients with UC showed blood hypercoagulable state.2.PLT,R,K,a angle,MA,LY30,FDP,D-D,PC activity,PS activity and vWF can be used as indexes to assess the severity of UC,and are associated with the disease activity.3.Compared with the routine coagulation tests,the indexes of TEG and thrombus markers were more sensitive to reflect the true coagulation status of UC patients.