摘要
目的研究强直性脊柱炎(AS)人类白细胞表面抗原B27阳性(HLA-B27+)患者凝血功能与炎性活动指标的相关性。方法回顾性选取2020年1月至2023年12月山西白求恩医院收治入院的80例AS HLA-B27+患者,将其设为病例组;同时选取同一时期入院的80名体检健康者,将其设为对照组。比较两组研究对象的凝血4项指标[凝血酶时间(TT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]、血小板相关指标[血小板计数(PLT)、纤维蛋白降解产物(FDP)、D二聚体]、炎性活动指标[红细胞沉降率(ESR)、C反应蛋白(CRP)]、血栓形成相关因子[纤溶酶原激活剂抑制剂(PAI)、血小板颗粒膜蛋白(GMP)140、前列环素(PGI2)、血栓素A_(2)(TXA_(2))]。同时,病例组患者接受Batch疾病活动度指数(BASDAI)评估,参考评估结果分为疾病减轻组(<4分,n=39)、疾病活动组(≥4分,n=41),比较疾病减轻组和疾病活动组患者的上述观察指标水平。结果病例组患者的PLT绝对计数、FDP、D-二聚体、FIB均明显高于对照组,APTT短于对照组,差异均有统计学意义(P<0.05)。病例组与对照组的TT、PT水平比较,差异均无统计学意义(P>0.05)。病例组ESR、CRP、PAI、GMP140、TXA_(2)水平均明显高于对照组,PGI2水平明显低于对照组,差异均有统计学意义(P<0.05)。疾病活动组的PLT、D-二聚体均明显高于疾病减轻组,差异均有统计学意义(P<0.05);疾病活动组与疾病减轻组患者的TT、FIB、APTT、PT、FDP水平比较,差异均无统计学意义(P>0.05)。疾病活动组患者的ESR、CRP、PAI、GMP140、TXA_(2)水平均明显高于疾病减轻组,PGI2水平明显低于疾病减轻组,差异均有统计学意义(P<0.05)。病例组患者ESR、CRP与PGI2呈负相关(P<0.05),与PAI、GMP140、TXA_(2)、PLT呈正相关(P<0.05);且CRP与D-二聚体呈正相关(P<0.05)。结论AS HLA-B27+患者的凝血-纤溶功能多存在异常,且疾病活动期时血液高凝发生风险更高,可能与炎症因子活跃过度有关。
Objective To investigate the correlation between coagulation function and inflammatory activity in patients with ankylosing spondylitis(AS)with human leukocyte surface antigen B27 positive(HLA-B27+).Methods Eighty AS HLA-B27+patients admitted to Shanxi Bethune Hospital from January 2020 to December 20203 were retrospectively selected as the case group;80 healthy person admitted during the same period were selected as the control group.Four indicators[thrombin time(TT),fibrinogen(FIB),activated partial thromboplastin time(APTT),prothrombin time(PT)],platelet-related index[platelet count(PLT),fibrin degradation product(FDP),D-dimer],inflammatory activity[red cell sedimentation rate(ESR),C reactive protein(CRP)],thrombosis-related factor[plasminogen activator inhibitor(PAI),platelet granule membrane protein(GMP140),prostacyclin(PGI 2),thromboxane A_(2)(TXA_(2))]of the two groups were compared;at the same time,patients in the case group underwent the Batch disease activity index(BASDAI)assessment,the reference evaluation results were divided into the disease reduction group(<4 points,n=39),the disease activity group(4 points,n=41),the levels of the above observed indicators were compared between the disease reduction group and the disease activity group.Results The PLT absolute count,FDP,D-dimer and FIB in the case group were significantly higher than those in the control group,APTT was shorter than that in the control group,the differences were statistically significant(P<0.05);there were no statistically significant differences in TT and PT levels between the case group and the control group(P>0.05).The levels of ESR,CRP,PAI,GMP140 and TXA_(2) in the case group were significantly higher than those in the control group,PGI 2 level was significantly lower than that in the control group,the differences were statistically significant(P<0.05).The PLT and D-dimer in the disease activity group were significantly higher than those in the disease remission group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the levels of TT,FIB,APTT,PT and FDP between the disease activity group and the disease remission group(P>0.05).The levels of ESR,CRP,PAI,GMP140 and TXA_(2) in the disease activity group were significantly higher than those in the disease remission group,and the level of PGI 2 was significantly lower than that in the disease remission group,the differences were statistically significant(P<0.05).ESR and CRP in the case group were negatively correlated with PGI 2(P<0.05),and positively correlated with PAI,GMP140,TXA_(2) and PLT(P<0.05).CRP was positively correlated with D-dimer(P<0.05).Conclusion The coagulation-fibrinolysis function is mostly abnormal in AS HLA-B27+patients,and it has a higher risk of blood hypercoagulability during the disease activity period,which may be related to the excessive activity of inflammatory factors.
作者
贺晓红
贺勋
车国柱
李月平
HE Xiao-hong;HE Xun;CHE Guo-zhu(Department of Laboratory,the Third Hospital of Shanxi Medical University,Taiyuan Shanxi 030032,China;Department of Anesthesiology,the 985 Hospital of the PLA Joint Logistic Support Force,Taiyuan Shanxi 030001,China;Department of Rheumatology and Immunology,Shanxi Bethune Hospital(Tongji Shanxi Hospital,Shanxi Academy of Medical Sciences),the Third Hospital of Shanxi Medical University,Taiyuan Shanxi 030032,China)
出处
《临床和实验医学杂志》
2024年第20期2165-2168,共4页
Journal of Clinical and Experimental Medicine
基金
山西省2022年青年计划项目(编号:20220473-114)。
关键词
强直性脊柱炎
人类白细胞表面抗原B27阳性
凝血功能
炎性活动指标
疾病活动期
Ankylosing spondylitis
Human leukocyte surface antigen B27 positive
Coagulation function
Inflammatory activity indicators
Disease activity period
