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| 1 | Multipotent role of platelets in inflammatory bowel diseases:A clinical approach显示文摘There is evidence that inflammatory bowel diseases(IBD)combine both inflammation and coagulation in their pathogenesis and clinical manifestations.Although platelets(PLT)are well known for their role in hemo stasis,there are a rising number of studies supporting their considerable role as inflammatory amplifiers in chronic inflammatory conditions.IBD are associated with several alterations of PLT,including number shape,and function,and these abnormalities are main ly attributed to the highly activated state of circulating PLT in IBD patients.When PLT activate,they increase in size,release a great variety of bio-active inflamma tory and procoagulant molecules/particles,and express a variety of inflammatory receptors.These inflamma tory products may represent a part of the missing link between coagulation and inflammation,and can be considered as possible IBD pathogenesis instigators.In clinical practice,thrombocytosis is associated both with disease activity and iron deficiency anemia.Controlling inflammation and iron replacement in anemic patient usually leads to a normalization of PLT count.The aim of this review is to update the role of PLT in IBD and present recent data revealing the possible therapeutic implications of anti-PLT agents in future IBD remedies. | Evangelos Voudoukis Konstantinos Karmiris Ioannis E Koutroubakis | 2014 | World Journal of Gastroenterology2014，20，12： | 27 |
| 2 | Venous thrombosis and prothrombotic factors in inflammatory bowel disease显示文摘Patients with inflammatory bowel disease(IBD)may have an increased risk of venous thrombosis(VTE).PubMed,ISI Web of Knowledge and Scopus were searched to identify studies investigating the risk of VTE and the prevalence of acquired and genetic VTE risk factors and prothrombotic abnormalities in IBD.Overall,IBD patients have a two-to fourfold increased risk of VTE compared with healthy controls,with an overall incidence rate of 1%-8%.The majority of studies did not show significant differences in the risk of VTE between Crohn’s disease and ulcerative colitis.Several acquired factors are responsible for the increased risk of VTEin IBD:inflammatory activity,hospitalisation,surgery,pregnancy,disease phenotype(e.g.,fistulising disease,colonic involvement and extensive involvement)and drug therapy(mainly steroids).There is also convincing evidence from basic science and from clinical and epidemiological studies that IBD is associated with several prothrombotic abnormalities,including initiation of the coagulation system,downregulation of natural anticoagulant mechanisms,impairment of fibrinolysis,increased platelet count and reactivity and dysfunction of the endothelium.Classical genetic alterations are not generally found more often in IBD patients than in nonIBD patients,suggesting that genetics does not explain the greater risk of VTE in these patients.IBD VTE may have clinical specificities,namely an earlier first episode of VTE in life,high recurrence rate,decreased efficacy of some drugs in preventing further episodes and poor prognosis.Clinicians should be aware of these risks,and adequate prophylactic actions should be taken in patients who have disease activity,are hospitalised,are submitted to surgery or are undergoing treatment. | Fernando Magro Jo?o-Bruno Soares Dália Fernandes | 2014 | World Journal of Gastroenterology2014，20，17： | 27 |
| 3 | 凝血功能检测对评估溃疡性结肠炎患者血液高凝状态的价值显示文摘目的探讨凝血功能指标评估溃疡性结肠炎(UC)患者血液高凝状态的价值。方法检测UC患者(UC组,25例)和非炎症性肠病患者(NIBD组,34例)常规凝血试验、血栓弹力图(TEG)和血栓标记物。常规凝血参数包括凝血酶原时间(PT)、APTT、凝血酶时间(TT)、国际标准化比值(INR)、纤维蛋白原(Fib)、Plt;TEG参数包括凝血因子反应时间(R)、Fib反应时间(K)、凝固角(α角)、最大振幅(MA)、纤维蛋白溶解率(LY30);血栓标记物包括Fib降解产物(FDP)、D-二聚体(D-D)、抗凝血酶-Ⅲ(AT-Ⅲ)、蛋白C(PC)活性、蛋白S(PS)活性、血管性血友病因子抗原(vWF)。比较不同病情程度UC患者各指标与疾病活动度的关系。结果 (1)在常规凝血试验指标中,UC组PT、APTT、INR、Fib、Plt高于NIBD组(P<0.01),TT低于NIBD组(P<0.05);不同病情程度患者间仅Plt差异有统计学意义(P<0.05)。(2)在TEG指标中,UC组α角、MA、LY30较NIBD组升高(P<0.01),UC组R、K较NIBD组降低(P<0.01);不同病情程度患者间R、K、α角、MA、LY30差异有统计学意义(P<0.05),α角、MA、LY30与疾病活动度呈正相关(P<0.01),R、K与疾病活动度呈负相关(P<0.01)。(3)在血栓标记物指标中,UC组FDP、D-D、vWF高于NIBD组(P<0.05),UC组AT-Ⅲ、PC活性、PS活性低于IBD组(P<0.05);不同病情程度患者FDP、D-D、PC活性、PS活性、vWF差异有统计学意义(P<0.05),FDP、D-D、vWF与疾病活动度呈正相关(P<0.01),AT-Ⅲ、PC活性、PS活性与疾病活动度呈负相关(P<0.05)。结论与常规凝血试验指标相比,TEG和血栓标记物指标能更敏感地反映UC患者的高凝状态。 | 胡妍妍 沈永华 于成功 邹晓平 张晓琦 | 2017 | 江苏医药2017，43，11： | 21 |
| 4 | Inflammatory bowel disease:Epidemiology,pathology and risk factors for hypercoagulability显示文摘Hypercoagulability observed in patients with inflammatory bowel diseases(IBD)may lead to thromboembolic events(TE),which affect the venous and arterial systems alike and are an important factor in patients’morbidity and mortality.The risk of TE in IBD patients has been demonstrated to be approximately threefold higher as compared to the general population.The pathogenesis of thrombosis in IBD patients is multifactorial and not fully explained.The most commonly listed factors include genetic and immune abnormalities,disequilibrium between procoagulant and anticoagulant factors,although recently,the role of endothelial damage as an IBD-triggering factor is underlined.Several studies report that the levels of some coagulation enzymes,including fibrinogen,factorsⅤ,Ⅶ,Ⅷ,active factorⅪ,tissue factor,prothrombin fragment 1+2and the thrombin-antithrombin complex,are altered in IBD patients.It has been demonstrated that there is a significant decrease of tissue plasminogen activator level,a marked increase of plasminogen activator inhibitor type 1 and thrombin-activable fibrinolysis inhibitor,a significantly lower level of antithrombinⅢand tissue factor pathway inhibitor.IBD patients have been also observed to produce an increased amount of various anticoagulant antibodies.Hyperhomocysteinemia,which is a potential risk factor for TE was also observed in some IBD patients.Further studies are necessary to assess the role of coagulation abnormalities in IBD etiology and to determine indications for thromboprophylactic treatment in patients at high risk of developing TE. | Danuta Owczarek Dorota Cibor Mikolaj K Glowacki Tomasz Rodacki Tomasz Mach | 2014 | World Journal of Gastroenterology2014，20，1： | 16 |
| 5 | 炎症性肠病患者凝血指标变化及其临床意义研究显示文摘目的探讨炎症性肠病(IBD)患者凝血指标的变化,及其与疾病活动程度的关系。方法回顾性分析2012年3月至2015年3月就诊的67例IBD患者及50例健康者血小板计数(PLT)、血小板平均体积(MPV)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)等指标检测结果,比较患者与健康者的差异,不同病情程度患者之间的差异,以及各指标与疾病活动指数的相关性。结果与健康者相比,IBD患者PLT、PT和FIB升高,MPV下降;不同病情严重程度溃疡性结肠炎患者间PLT、MPV、PT和FIB水平比较差异有统计学意义(P<0.05),不同病情严重程度克罗恩病患者间PLT、MPV和FIB水平比较差异有统计学意义(P<0.05);PLT和FIB与IBD疾病活动指数呈正相关,MPV与疾病活动指数呈负相关。结论 IBD患者体内凝血功能异常,表现为PLT升高、MPV下降,PT延长及FIB升高,PLT、MPV和FIB或可作为判断IBD疾病活动性的指标。 | 安毅 康凯 贺亚妮 | 2016 | 检验医学与临床2016，13，16： | 14 |
| 6 | Inflammatory bowel disease and thromboembolism显示文摘Patients with inflammatory bowel disease(IBD) have an increased risk of vascular complications. Thromboembolic complications,both venous and arterial,are serious extraintestinal manifestations complicating the course of IBD and can lead to significant morbidity and mortality. Patients with IBD are more prone to Thromboembolic complications and IBD per se is a risk factor for thromboembolic disease. Data suggest that thrombosis is a specific feature of IBD that can be involved in both the occurrence of thromboembolic events and the pathogenesis of the disease. The exact etiology for this special association between IBD and thromboembolism is as yet unknown,but it is thought that multiple acquired and inherited factors are interacting and producing the increased tendency for thrombosis in the local intestinal microvasculature,as well as in the systemic circulation. Clinicians' awareness of the risks,and their ability to promptly diagnose and manage TEs are of vital importance. In this review we discuss how thromboembolic disease is related to IBD,specifically focusing on:(1) the epidemiology and clinical features of thromboembolic complications in IBD;(2) the pathophysiology of thrombosis in IBD;and(3) strategies for the prevention and management of thromboembolic complications in IBD patients. | Petros Zezos Georgios Kouklakis Fred Saibil | 2014 | World Journal of Gastroenterology2014，20，38： | 12 |
| 7 | 凝血功能紊乱与炎症性肠病的关联研究显示文摘炎症性肠病(inflammatory bowel disease,IBD)指病因未明的慢性炎症性肠病,包括溃疡性结肠炎和克罗恩病。炎症性肠病的病因和发病机制尚未完全明确,目前认为由多因素相互作用所致,主要包括遗传(调节细胞因子网络的基因多态性、先天性编码下调回路的基因敲除)、免疫(先天性固有免疫结构功能的紊乱、消极的防御装置)、感染(微生物的多重性);环境(吸烟、饮食、卫生条件等)[1]。近年研究发现炎症性肠病患者易患静脉血栓栓塞,发病率及病死率均显著增高,表明炎症性肠病与凝血功能存在相关性。 | 徐帆 陈璐 涂斌 | 2017 | 现代中西医结合杂志2017，26，22： | 8 |
| 8 | 血小板与淋巴细胞比值对溃疡性结肠炎鉴别诊断及其严重程度判定的临床意义分析显示文摘目的评估血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)对溃疡性结肠炎的临床应用价值。方法选取2009年6月至2016年6月于上海长海医院就诊的192例患者,其中溃疡性结肠炎97例,肠易激综合征95例,分析2组患者PLR差异,并评价PLR对溃疡性结肠炎诊断的敏感性、特异性;通过改良的Mayo评分系统评估溃疡性结肠炎疾病活动度,结肠镜确定病变蔓延部位,评估PLR与疾病活动度及病变蔓延部位的相关性。结果与肠易激综合征对照组相比,溃疡性结肠炎患者白细胞计数、血小板计数、PLR、红细胞沉降率、C反应蛋白显著增高,血红蛋白显著降低,差异具有统计学意义(P<0.05)。PLR在溃疡性结肠炎与肠易激综合征组间差异有统计学意义,通过受试者工作曲线(receiver operating characteristic curve,ROC)分析,PLR检测的敏感度和特异度分别为67%和58%。肠易激综合征和轻、中、重度溃疡性结肠炎的PLR分别是123.73±60.47、114.32±43.66、160.19±56.52、253.35±86.82。肠易激综合征PLR与轻度溃疡性结肠炎PLR比较差异无统计学意义(P=0.54),与中、重度溃疡性结肠炎PLR比较差异均有统计学意义(P<0.05);轻、中、重度溃疡性结肠炎PLR比较差异均有统计学意义(P<0.05)。PLR在溃疡性结肠炎不同病变蔓延部位之间差异无统计学意义(P>0.05)。结论 PLR在溃疡性结肠炎与肠易激综合征鉴别诊断中具有一定价值和临床意义,并且可以判断溃疡性结肠炎的活动度。 | 景丽玲 高谦 周正宇 孟洁 何莹 刘善荣 | 2017 | 海军医学杂志2017，38，5： | 7 |
| 9 | 炎症性肠病血液高凝状态的研究进展显示文摘炎症性肠病(inflammatory bowel disease,IBD),主要包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn disease,CD)。IBD的病因和发病机制目前还未完全明确,近年研究发现IBD患者存在血栓栓塞风险,IBD炎症反应的存在导致凝血物质及凝血过程异常,同时凝血级联反应促进炎症反应形成恶性循环。此外, | 郭易娟 梅浙川 | 2016 | 重庆医学2016，45，5： | 2 |
| 10 | What's hot in inflammatory bowel disease in 2011?显示文摘Ulcerative colitis and Crohn's disease(CD) are the two major forms of inflammatory bowel disease(IBD).In this highlight topic series of articles,the most recent advances in the IBD field are reviewed,especially the newly described cytokines,including the therapeutic implications for their manipulation.In addition,the interplay between the intestinal microbiota and the host is reviewed,including the role of defensins and dysbiosis in CD pathogenesis.Finally,the importance of the non immune systems such as endothelial cells and the hemostatic system are highlighted as new players in IBD pathogenesis. | Silvio Danese | 2011 | World Journal of Gastroenterology2011，17，5： | 1 |
| 11 | 炎症性肠病发生静脉血栓的危险因素与治疗进展显示文摘炎症性肠病(IBD)是一种累及回肠、结肠、直肠,病因尚未明确的肠道慢性疾病,其总发病率在各国均有所增加。IBD的肠道并发症是造成患者病情反复发作和死亡率高的重要原因,其中IBD合并静脉血栓形成是导致患者病情预后不良的重要原因之一。IBD合并静脉血栓形成由许多遗传和获得性危险因素的相互作用共同导致,具体发病机制尚未明确。本文主要对IBD合并静脉血栓栓塞的危险因素及治疗进展进行论述。 | 周婵 罗娟 缪应雷 | 2021 | 临床内科杂志2021，38，2： | 1 |
| 12 | 血小板功能和参数在溃疡性结肠炎中的变化及意义的研究进展显示文摘溃疡性结肠炎(UC)是一种慢性非特异性的炎性肠病,其发生部位主要位于肠道黏膜和黏膜下层,病情反复发作,病程迁延不愈。随着人们饮食结构的不断改变,生活节奏的不断加快,UC的发病率逐年升高。血小板的异常参与了UC的病理改变,对于判断UC的发病部位、疾病的严重程度及预后具有重要的意义。该文主要对UC患者血小板功能和参数的变化及意义作一综述。 | 张思佳 金世柱 罗鲲鹏 | 2021 | 国际消化病杂志2021，41，4： | 0 |
| 13 | 溃疡性结肠炎患者发生肺栓塞的病例分析显示文摘目的提高对溃疡性结肠炎并发肺栓塞的临床诊疗认识。方法对北京朝阳医院2018年4月22日收治的1例溃疡性结肠炎并发肺栓塞患者的病例进行回顾分析,同时复习文献资料,了解炎症性肠病并发血栓栓塞的机制、影响因素、临床特征及诊疗方案等。结果该例患者入院后泵入普通肝素抗凝治疗,行各项实验室检查及影像学检查。1周后复查心脏超声示左房增大,肺动脉增宽、升主动脉轻度增宽,心包积液(微量),右肺动脉起始处血栓可能,病情较治疗前好转,改为口服利伐沙班抗凝,患者病情逐渐平稳出院。炎症性肠病患者发生动、静脉血栓的概率较高,其机制可能与内皮功能障碍、血小板活化、凝血功能及纤溶功能的异常改变等有关,明确病史、结合临床可以帮助有效辨别和诊疗炎症性肠病并发的肺栓塞等血栓栓塞性疾病。结论肺栓塞是溃疡性结肠炎较易发生的严重血栓栓塞性并发症,炎症性肠病诱导的血栓事件被普遍低估,应当对此类患者进行静脉血栓的评估和干预,以预防静脉血栓的形成。 | 崔向丽 宗宇桐 张帅 龚娟妮 刘丽宏 杨媛华 | 2018 | 中国医刊2018，53，10： | 0 |
| 14 | 基于肺与大肠相表里理论论治溃疡性结肠炎显示文摘溃疡性结肠炎是一种慢性炎症性肠病,属于中医学泄泻、痢疾、肠澼等范畴。中医认为肺与大肠在经络、生理以及病理方面关系密切,提出从肺论治肠道疾病。本文从肺与大肠经络相关、气机宣降、津液代谢及现代肺肠轴理论等方面,论述从肺论治的可行性,为治疗溃疡性结肠炎提出新的诊疗思路。 | 张楚楚 蒋廷 华鑫 钱素婷 曹泽鹏 刘庆生 | 2023 | 新中医2023，55，15： | 0 |
| 15 | 炎性肠病患者凝血功能的相关分析显示文摘目的研究炎性肠病(inflammatory bowel disease,IBD)患者凝血相关指标的变化情况,并评估各指标对炎性肠病活动性的诊断价值。方法选取2019年1月至2022年12月金华市中心医院收治的228例IBD患者作为IBD组,其中又分为溃疡性结肠炎(ulcerative colitis,UC)组患者118例,克罗恩病(Crohn’s disease,CD)组患者110例。将UC组分为缓解组(n=52)和活动组(n=66),CD组分为缓解组(n=40)和活动组(n=70)。另选取100名健康成人作为对照组。比较各组的血浆凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D)、血小板(platelet,PLT)、平均血小板体积(mean platelet volume,MPV)等指标水平。采用受试者操作特征(receiver operator characteristic,ROC)曲线评估各参数对疾病活动性的研究价值。结果UC组和CD组的PT、APTT、FIB、D-D、PLT均高于对照组,TT、MPV均低于对照组,差异均有统计学意义(P<0.05)。CD组的PLT高于UC组,FIB、D-D、MPV均低于UC组,差异均有统计学意义(P<0.05),UC活动组的FIB、D-D、PLT均高于缓解组,MPV低于缓解组,差异均有统计学意义(P<0.05)。CD活动组的PT、FIB、D-D、PLT高于缓解组,凝血酶原活动度(prothrombin activity,PTA)、MPV低于缓解组,差异均有统计学意义(P<0.05)。UC患者的ROC曲线分析中,FIB和D-D的曲线下面积较大,分别为0.837和0.859,FIB敏感度为70%,特异性为88%,D-D敏感度为86%,特异性为72%。CD患者的ROC曲线分析中,PLT和MPV的曲线下面积较大,分别为0.845和0.802,PLT敏感度为76%,特异性为84%,MPV敏感度为70%,特异性为90%。结论FIB、D-D是评估UC活动性较好的指标,PLT、MPV是评估CD疾病活动性较好的指标,可用于临床对IBD的评估。 | 施竞超 王利民 王华斌 | 2023 | 中国现代医生2023，61，20： | 0 |
| 16 | t-PAIC、TM和血栓弹力图在溃疡性结肠炎患者活动度评估中的应用显示文摘目的探讨组织纤溶酶原激活物-抑制剂复合物(t-PAIC)、血栓调节蛋白(TM)在溃疡性结肠炎(UC)患者中的水平,以及t-PAIC、TM和血栓弹力图(TEG)评估UC患者活动度的价值。方法选取2021年2月至2023年3月在新乡市第二人民医院住院治疗的82例UC患者为试验组,按照1∶1的比例同时选取同期在新乡市第二人民医院体检的82例健康体检者作为对照组。比较试验组及对照组纤维蛋白(原)降解产物(FDP)、D-二聚体(D-D)、t-PAIC、TM水平及TEG各指标[凝血反应时间(R)、血块动力时间(K)、凝固角(Angle角)、纤维蛋白溶解率(LY30)及最大振幅(MA)]差异。根据改良Mayo评分系统对UC患者进行分组并比较不同病情各组之间FDP、D-D、t-PAIC、TM水平及TEG各指标差异。采用多因素Logistic回归分析t-PAIC、TM和TEG各指标对UC患者疾病活动指数评分的影响;采用受试者工作特征(ROC)曲线分析各指标对UC患者活动度的评估价值。结果与对照组相比,试验组血清FDP、D-D、t-PAIC、TM水平明显升高(P<0.05)。TEG检测结果显示试验组R、K明显低于对照组,Angle角、LY30及MA明显高于对照组,差异均有统计学意义(P<0.05)。根据改良Mayo评分将82例UC患者分为缓解期组8例,轻度活动组26例,中度活动组29例及重度活动组19例。UC不同病情各组间FDP、D-D、t-PAIC、TM水平及R、K、Angle角、LY30、MA比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,t-PAIC、TM、LY30是UC患者疾病活动度的影响因素(OR=1.719、1.531、2.067,均P<0.05)。以Mayo评分<6分的UC患者为对照,绘制ROC曲线,结果显示t-PAIC、TM、LY30鉴别诊断UC患者活动度的曲线下面积(AUC)分别为0.784(95%CI:0.684~0.883)、0.738(95%CI:0.629~0.847)、0.826(95%CI:0.737~0.916)。结论t-PAIC、TM及LY30是UC患者疾病活动度的影响因素,检测t-PAIC、TM及LY30可以有效评估UC患者的活动度。 | 詹江辉 杨雪 郭晓鹤 | 2024 | 检验医学与临床2024，21，6： | 0 |
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