The Study Of D-dimer,APTT And Fibrinogen In Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory bowel disease, and the entire intestine may be involved. In patients'life,it is always recurrent and mainly occurs in diffuse distribution involving the mucous layer of the colon and rectum.. The symptoms of ulcerative colitis are diarrhea, nongxue stool, abdominal pain and frequent defecation. The degree of severity of the disease varies and the disease is reccrent. There is active state and stable state according to clinical symptoms. With the advanced means of clinic, there is an upward trend of its incidence in recent years. Most of ulcerative colitis patients may experience from the activities to stable state and its recurrence. Therefore how to make a good treatment can make a direct impact on the prognosis of disease and patients'quality of lives. Accurate assessment of the activity of ulcerative colitis can guide the correct treatment .There is a report that there is a thrombosis state which is prone to thrombosis in the mucosa of ulcerative colitis patients. Thrombosis rate is about 1.2℅～7.1℅ and it can be found in extensive positions. Deep Vein Thrombosis is the most common, followed by pulmonary thrombosis and other parts. There is non-specific performance before a thrombosis. Once it happens, a great threaten to health will occur. Base on these, we detected D-dimmer and fibrinogen of 60 patients with UC to guide clinical treatment. D-dimer is the specific degradation product of cross-linked fibrin. Its high level can reflect increasing thrombin or the enhanced secondary fibrinolytic activity. It is the molecular marker which shows a hypercoagulable state and secondary hyper-fibrinolysis. APTT and Fg is the index of blood coagulation. They may be related to abnormal activity of unlerative colitis.Patients who were diagnosed with UC in China-japan friendship hospital in changchun from March 2007 to April 2008 were selected. Based on their clinical features, endoscopic examination and organization characteristics we can draw diagnosis. These selected cases meet the diagnostic criteria for ulcerative colitis which was amend in 2000 National conference about the inflammatory bowel disease. Other systematic diseases such as cardio-cerebral vascular diseases, liver, kidney patients with high state of condensate were excluded. According to the diagnostic criteria for UC, there were 60 active cases .According to the severity we divided them into three groups: mild, moderate and severe. 20 healthy volunteers were selected for the control group. 28 patients were selected from active group and divided into anticoagulant therapy group and non-anticoagulant control group. Four weeks later, we detected D-dimer, APTT and Fib.Morning–fasting vein blood of 2ml was collected in all subjects. 3000 centrifugal per minute was performed for 10 minutes and immediate detection of the following indexes was done.APTT testing was detected by using solidification while D-dimer and Fg by immune turbidity. The apparatus was ACL9000 coagulometer. SPSS10.0 software was used for statistical analysis, count information was expressed with the mean±standard deviation while comparison of these groups were done by t test. There was statistical significance if p <0.05.Results: the level of D-dimer in active group is higher than that of control group with a significant difference (P﹤0.01). The level of APTT in active group is lower than that of control group and there was a significant difference (P﹤0.05). The level of FIB in active group is higher than that of control group and there was a significant difference (P﹤0.01). And the level of D-dimer in severe group is higher than that of mild group with a significant difference (P﹤0.01) while the level of D-dimer in moderate group is higher than that of control group with a significant difference (P﹤0.05). The level of D-dimer in severe group is higher than that of moderate group (P﹤0.01), and there was a significant difference. After anticoagulant therapy, the D-dimer and fibrinogen decreased significantly comparing with non-anticoagulant treatment group. There was no significant difference in D-dimer positive rate, fibrinogen positive rate and positive rate of ESR.Conclusion1. D-dimer and FIB in ulcerative colitis patients are higher than that of the control group. There was statistical significance. And more sevious the disease is, the higher the D-dimer/FIB and the lower APTT is in blood.2. It shows that secondary fibrinolysis occurred in blood of patients of ulcerative colitis and the blood of ulcerative colitis patients was inclined to coagulation. We should detect bleeding and clotting time in order to give some appropriate anticoagulant therapy.3. D-dimer and fibrinogen can be used as index of disease activity.