| Background:Chronic urticaria(CU) is a common skin disease,whose etiology is not very clear yet.As the data we already know,25%-50%are autoimmune urticaria,which is caused by the autoantibodies against the alpha subunit of the high-affinity IgE receptor on mast cell and autoantibodies against IgE,but other 30%-40%are thought to be idiopathic for no identified causes.Auto serum skin test(ASST) can be carried out to determine these autoantibodies,whose sensitivity and specificity are just about 80%.What is interesting is that in patients with CU caused by physical factors been excluded the positive rate of ASST is about 50%,while the positive rate of APST is to 95%.There were also cases reporting injecting heparin subcutaneously or using warfarin to treat patients with CU got good effect.More studies showed heparin could inhibit reaction of skin to auto serum and inhibit histamine-releasing of basophilic granulocyte in vivo.So some scholars did research of CU and blood coagulation,the results revealed concentrations of plasma D-dimer,FⅦa and F1+2 were higher in patients with CU than in normal controls,but concentration of plasma FⅫa had no difference between patients and controls.There was a positive correlation between plasma FⅦa content and F1+2 content.Biopsies of skin lesion showed expression of TF was higher in cells with severe inflammation.These founds indicated abnormal activation of exogenous coagulation pathway in patients with CU.Recently,the hot research points finds many factors of blood coagulation have complicated relations with inflammation.On this foundation,we did primary research to determine if patients with CU have activation of exogenous blood coagulation pathway and discuss the roles coagulation factors playing in pathogenesis of CU. Objective:To know common sick status and DQLI of patients with CU.To evaluate the role of blood coagulation in the pathogenesis of chronic urticaria by investigating the PT,APTT,concentration of plasma D-dimer, concentration of plasma activated factorⅦin patients with chronic urticaria and evaluate the relationship between concentration of plasma D-dimer and concentration of FⅦa,at the same time,the correlation between concentration of FⅦa and the disease activity and correlation between concentration of TAT and the disease activity are to be confirmed.By doing this,we hope to discover how coagulation parameters act in CU and find possible therapy clues of incurable CU.Methods:Studied 30 patients with CU and 30 normal controls and investigated common sick status and DQLI of patients,whose disease activity was also estimated.Both in the 30 patients and 30 healthy subjects,PT and APTT were measured by coagulation method,plasma D-dimer content was determined by turbidimetric immunoassay,plasma FⅦa content was investigated by ELISA. Four correlations,which are plasma FⅦa and TAT content,TAT and D-dimer content,concentration of FⅦa and disease activity and concentration of TAT and disease activity,were studied.Results:Common sick status,DQLI is showed in chart 1 and chart 2,while picture 1 shows disease activities.The results of PT,APTT,plasma FⅦa,TAT and D-dimer content are in chart(5-9).Compared with the normal controls, there was no significant difference of PT and APTT in patients with chronic urticaria(P＞0.05,separately).But the plasma D-dimer content was higher in patients than controls(P＜0.05) and plasma FⅦa content was significant higher in patients than that in controls(P＜0.001).There was a positive correlation between concentration of FⅦa and TAT(P＜0.001),the similar correlation also existed between concentration of TAT and D-dimer(P＜0.001),and the level of FⅦa,but not the level of TAT(P＞0.05) was significantly correlated with the disease activity(P＜0.05).Conclusion:From analysis of this study,CU does much negative influence to patients' life quality.And elevated concentrations of plasma FⅦa,D-dimer and TAT and the positive correlations between FⅦa and TAT content,TAT and D-dimer content prove abnormal activation of exogenous blood coagulation. While the fact that concentration of plasma FⅦa and disease activity has positive correlation,which doesn't exist between plasma TAT content and disease activity,suggests that the activation of blood coagulation may play a part in the pathogenesis of chronic urticaria.Coagulation factors,especially FⅦa,may involve in the pathogenesis of chronic urticaria.
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