Correlation Analysis Between Coagulation Dysfunction And The Activity Of Inflammatory Bowel Disease

ObjectiveTo analyze the changes of coagulation parameters in the occurrence and development of disease in hospitalized patients with inflammatory bowel disease(IBD)so as to explore whether or not there is a blood hyper-coagulation state and its relationship with intestinal inflammation in patients with IBD,and to provide evidence for coagulation parameters as disease severity predictors and for preventive anticoagulant therapy.Methods141 patients with IBD hospitalized from January 2016 to December 2018 in the First Affiliated Hospital of Dalian Medical University were selected as IBD group,which was further divided into UC group(97 cases)and CD group(44 cases).According to Mayo score,the UC group was divided into the remission group(12 cases),the mild group(20 cases),the moderate group(36 cases)and the severe group(29 cases).According to the Best CDAI,the CD group was divided into the remission group(10 cases),the mild group(10 cases),the moderate group(15 cases)and the severe group(9 cases).The diagnosis of UC and CD was based on the“Consensus on the diagnosis and treatment of inflammatory bowel disease” in guangzhou in 2012”.60 healthy persons undergoing well-being check at the First Affiliated Hospital of XXXX University as the control group.Differences in coagulation parameters between the IBD group and the control group,UC group and the CD group and among remission,mild,moderate,and severe group were compared.These coagulation parameters include platelet(PLT),mean platelet volume(MPV),prothrombin time(PT),and activated partial thromboplastin time(APTT),prothrombin activity(PTA),thrombin time(TT),fibrinogen(FIB),D-dimer(DDI),and international standard ratio(INR).Correlation analysis between the above coagulation parameters and disease activity index,erythrocyte sedimentation rate(ESR)and high-sensitivity C-reactive protein(CRP)were also carried out.Statistical analysis was performed using statistical software SPSS 23.0.Correlation analysis was performed using Pearson correlation analysis.All measurement data were expressed as mean ± standard deviation or median.Measurement data in accordance with normal distribution were compared by t test.Comparison between groups was analyzed by one-way analysis of variance.The nonnormal distribution measurement data is tested by rank sum;the count data is analyzed by chi-square test.P < 0.05 was considered statistically significant.Result1.In IBD group,PLT,DDI,INR and FIB were significantly higher than that in control group(P<0.01).MPV,TT and PTA were significantly lower than that in the control group(P<0.01).PT and APTT difference was not statistically significant.In UC group and CD group,PLT,MPV,FIB,DDI and PTA were significantly statistically significant than that in the control group(P<0.01).In addition,in UC group,TT was significantly lower than that in the control group(P<0.01).In CD group,PT and INR were significantly higher than those in the control group(P<0.01),but TT was significantly lower than that in the control group(P<0.05).2.DDI in UC group was higher than that in CD group(P<0.05),PT in CD group was higher than that in UC group(P<0.05),and INR was significantly higher than that in UC group(P<0.01).The remaining coagulation parameters had no statistical significance between the two groups.3.In UC group,PLT,DDI and FIB in severe group were significantly higher than those in remission group,mild group and moderate group(P all<0.01),MPV and PTA were significantly lower than those in remission group,mild group and moderate group(P all<0.01),while PT was only higher than that in mild group and remission group(P<0.05).But the difference in APTT among these subgroups was not statistically significant(P>0.05).Among CD subgroups,PLT and FIB in severe group were significantly higher and MPV was lower than those in remission group,mild group and moderate group(P<0.01),while PT was only significantly higher than that in the remission group(P<0.01),and DDI was higher than that in remission group and mild group(P<0.05),and PTA was lower than that in the remission group(P<0.05).4.Correlation analysis showed that PLT,PT,DDI,FIB and INR were positively correlated with modified Mayo score,ESR and CRP in UC group(P<0.01),but MPV and PTA were negatively correlated with modified Mayo score,ESR and CRP.(P<0.01).Furthermore,TT was negatively correlated with CRP(P<0.05).In CD group,FIB PLT,and DDI were positively correlated with CDAI,ESR and CRP(P<0.01,P<0.05),and PT was positively correlated with CDAI and CRP(P<0.05).MPV and PTA were negatively correlated with CDAI score,ESR and CRP(P<0.01),while TT was negatively correlated with ESR and CRP(P<0.05).Conclusion1.Hypercoagulation state exists in patients with IBD.2.Patients with IBD exhibit abnormal PLT,FIB,DDI,PT and PTA levels which are correlated with disease activity index,ESR and CRP.These coagulation parameters can be used as indicators to evaluate the degree of disease activity and to provide a theoretical basis for preventive anticoagulant therapy.