CAJ | 학술논문

目的探讨凝血因子、抗凝因子以及纤溶标志物与慢性荨麻疹(CU)发病的关系并分析CU在发作期与缓解期不同状态下凝血状态、补体水平以及炎症标志物水平改变的情况.方法 40例CU患者中缓解期CU 18例,发作期CU 22例,来自广州市血液中心的健康献血员40例作为健康对照组,用ELASA等方法检测凝血酶原片段F1+2(F1+2)、组织因子(TF)、血栓调节蛋白(TM)、高分子量激肽原(HMWK)、组织型纤溶酶原激活剂(t-PA)、C5a、C3、C4、血细胞沉降率(ESR)、抗溶血性链球菌O(ASO)、C反应蛋白(CRP)、类风湿因子(RF)水平,观察上述指标在CU发作期以及缓解期的改变.结果与健康对照组相比,CU患者血浆F1+2和HMWK水平明显升高(P＜0.01),而TF、TM和t-PA水平明显降低(P＜0.01).CU患者的血浆F1+2、HMWK以及t-PA水平与症状评分相关(r=0.81,P＜0.01;r=-0.39,P＜0.05;r=0.35,P＜0.05).CU患者发作期血浆F1+2水平较缓解期明显升高(P＜0.01).TF、TM、HMWK、t-PA、C5a、C3、C4、ESR、ASO、RF、CRP水平在发作期与缓解期的差异均无统计学意义.结论凝血因子、抗凝因子以及纡溶标志物均参与CU发病.CU发作期与缓解期存在着F1+2水平的明显差异,提示凝血因子可能在CU发生发展中起作用.
목적 탐토응혈인자、항응인자이급섬용표지물여만성담마진(CU)발병적관계병분석CU재발작기여완해기불동상태하응혈상태、보체수평이급염증표지물수평개변적정황.방법 40례CU환자중완해기CU 18례,발작기CU 22례,래자엄주시혈액중심적건강헌혈원40례작위건강대조조,용ELASA등방법검측응혈매원편단F1+2(F1+2)、조직인자(TF)、혈전조절단백(TM)、고분자량격태원(HMWK)、조직형섬용매원격활제(t-PA)、C5a、C3、C4、혈세포침강솔(ESR)、항용혈성련구균O(ASO)、C반응단백(CRP)、류풍습인자(RF)수평,관찰상술지표재CU발작기이급완해기적개변.결과 여건강대조조상비,CU환자혈장F1+2화HMWK수평명현승고(P＜0.01),이TF、TM화t-PA수평명현강저(P＜0.01).CU환자적혈장F1+2、HMWK이급t-PA수평여증상평분상관(r=0.81,P＜0.01;r=-0.39,P＜0.05;r=0.35,P＜0.05).CU환자발작기혈장F1+2수평교완해기명현승고(P＜0.01).TF、TM、HMWK、t-PA、C5a、C3、C4、ESR、ASO、RF、CRP수평재발작기여완해기적차이균무통계학의의.결론 응혈인자、항응인자이급우용표지물균삼여CU발병.CU발작기여완해기존재착F1+2수평적명현차이,제시응혈인자가능재CU발생발전중기작용.
Objective To determine the coagulation status as well as circulating levels of complement and inflammation markers in patients with chronic urticaria (CU) during acute attack and in remission,and to estimate the relationship of coagulant and anticoagulant factors as well as fibrinolytic markers with the development of chronic urticaira.Methods This study included 40 patients with CU (22 during acute attack and 18 in remission) and 40 healthy blood donors from the Guangzhou Blood Center.Venous blood samples were obtained from these subjects,and enzyme-linked immunosorbent assay (ELISA) was performed to measure the plasma levels of prothrombin fragrnent 1 +2 (F1 +2),tissue factor (TF),thrombomodulin (TM),high molecular weight kininogen (HMWK),tissue-type plasminogen activator (t-PA),C5a and serum levels of C3,C4,antistreptolysin O antibodies (ASO),rheumatoid factor (RF) and C-reactive protein (CRP).Erythrocyte sedimentation rate (ESR) was also determined in these patients.Comparisons of these parameters were carried out by using t test,and the correlation of these factors with CU was evaluated by using Spearman correlation coefficient.Results Compared with the healthy controls,the patients with CU showed significantly higher plasma levels of F1+2 and HMWK (both P ＜ 0.01),but lower levels of TF,TM and t-PA (all P ＜ 0.01).The plasma levels of F1 +2,HMWK,t-PA were significantly correlated with the symptom scores in patients with CU (r =0.81,P ＜ 0.01; r =-0.39,P ＜ 0.05; r =0.35,P ＜ 0.05).A significant increase was observed in the plasma concentration of F1 +2 in patients during acute attack compared with those in remission (P ＜ 0.01),whereas no significant differences were noted in the plasma levels of TF,TM,HMWK,t-PA,C5a,serum levels of C3,C4,ASO,RF and CRP or ESR between the two groups of patients (all P ＞ 0.05).Conclusions It seems that coagulation,anti-coagulation and fibrinolysis are all involved in the development of urticaria.There is an obvious difference in the plasma level of prothrombin F1 +2 between patients with CU during acute attack and in remission,suggesting that coagulation factors play a certain role in the initiation and progression of CU.