摘要
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。
Objective To investigate the levels of tissue plasminogen activator-inhibitor complex(t-PAIC)and thrombomodulin(TM)in the patients with ulcerative colitis(UC)and the value of t-PAIC,TM and thromboelastogram(TEG)in evaluating the activity of the patients with UC.Methods Eighty-two inpatients with UC treated in the Xinxiang Municipal Second People′s Hospital from February 2021 to March 2023 were selected as the experimental group,and 82 healthy subjects undergoing physical examination in this hospital during the same period were selected as the control group according to a ratio of 1∶1.The levels of fibrinogen degradation products(FDP),D-dimer(D-D),t-PAIC,TM and TEG indicators[coagulation reaction time(R),clot motility time(K),coagulation angle(Angle angle),fibrinolysis rate(LY30),and maximum amplitude(MA)]were detected.The differences of various indexes were compared between the experimental group and control group.According to the improved Mayo scoring system,the UC patients were grouped and the differences in FDP,D-D,t-PAIC,TM levels,and TEG indicators were compared among the disease groups with different disease conditions.The multivariate Logistic regression was used to analyze the impact of t-PAIC,TM,and TEG indicators on disease activity index scores in UC patients;the receiver operating characteristic(ROC)curve was used to analyze the evaluation value of various indicators on the activity of UC patients.Results Compared with the control group,the levels of serum FDP,D-D,t-PAIC and TM in the experimental group were significantly increased(P<0.05).The TEG examination results showed that the R and K values in the experimental group were significantly lower than those in the control group,while the Angle angle,LY30 and MA values were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).According to the modified Mayo score,82 patients with UC were divided into the remission group(8 cases),mild activity group(26 cases),moderate activity group(29 cases)and severe activity group(19 cases).The levels of FDP,D-D,t-PAIC,TM,as well as R,K,Angle angle,LY30 and MA had statistical differences among various groups of UC with different disease conditions(P<0.05).The results of multivariate Logistic regression analysis showed that t-PAIC,TM and LY30 were the influencing factors of disease activity in the patients with UC(OR=1.719,1.531,2.067,all P<0.05).Using UC patients with Mayo scores<6 points as the controls,ROC curves were drawn,and the results showed that the area under the curve(AUC)of t-PAIC,TM and LY30 for differentially diagnosing the activity of UC patients were 0.784(95%CI:0.684-0.883),0.738(95%CI:0.629-0.847)and 0.826(95%CI:0.737-0.916),respectively.Conclusion T-PAIC,TM and LY30 are the influencing factors of disease activity in UC patients.Testing t-PAIC,TM and LY30 could effectively evaluate the activity of UC patients.
作者
詹江辉
杨雪
郭晓鹤
ZHAN Jianghui;YANG Xue;GUO Xiaohe(Department of Clinical Laboratory,Xinxiang Municipal Second People′s Hospital,Xinxiang,Henan 453002,China;Department of Blood Transfusion,First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453100,China;Department of Gastroenterology,First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453100,China)
出处
《检验医学与临床》
2024年第6期770-774,共5页
Laboratory Medicine and Clinic
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20210539)。
作者简介
詹江辉,男,主管技师,主要从事免疫功能缺陷分析与感染性疾病方面的研究;通信作者:郭晓鹤,E-mail:742037540@qq.com。
