發(fā)布時(shí)間：2018-06-02 00:04

  本文選題：克羅恩病 + 凝血功能��； 參考：《南京大學(xué)》2014年碩士論文

【摘要】：研究目的：觀察克羅恩病(CD)患者凝血功能改變情況,討論影響患者凝血功能的風(fēng)險(xiǎn)因素。研究方法：將2013年6月至2013年12月期間我科就診CD患者作為研究對(duì)象,同時(shí)期健康志愿者作為對(duì)照組納入本研究,分別監(jiān)測(cè)以下指標(biāo)：炎癥活動(dòng)性指標(biāo)(hs-CRP, ESR, CDAI評(píng)分),血常規(guī)、常規(guī)凝血檢查,血栓彈力圖(TEG)檢查。按CDAI評(píng)分對(duì)患者進(jìn)行分組：A組(活動(dòng)期),A1組(中重度活動(dòng)期),B組(緩解期),C組(健康對(duì)照),比較各組間凝血功能變化情況,并分析引起凝血功能改變的風(fēng)險(xiǎn)因素。研究結(jié)果：入組病人共277例,其中活動(dòng)期87例,緩解期87例,健康對(duì)照103例。CD患者與健康對(duì)照組凝血四項(xiàng)指標(biāo)無(wú)明顯差異(p0.05),TEG參數(shù)R值、K值無(wú)明顯差異(p0.05),MA值、α值顯著增高(p0.05)；活動(dòng)期CD患者較緩解期、健康組MA值、α值顯著增高(p0.05),R值、K值無(wú)明顯差異(p0.05)；緩解期CD患者R值、K值、MA值無(wú)顯著差異(p0.05),α值增高(p0.05)；中重度活動(dòng)期CD患者較健康對(duì)照組R值、K值顯著降低(p0.05),較其余組MA值、α值顯著增高(p0.05)；各組間LY30、EPL值無(wú)顯著性差異(p0.05)。多元線性回歸分析發(fā)現(xiàn)CDAI、CRP、PLT與MA值呈正相關(guān)(r=0.463,p0.05),CDAI與α值呈正相關(guān)(r=0.323,p0.05)。研究結(jié)論：CD患者存在凝血功能亢進(jìn),主要表現(xiàn)為血小板型高凝,凝血因子活性、纖溶系統(tǒng)無(wú)明顯改變。緩解期CD患者凝血功能無(wú)明顯異常,活動(dòng)期CD患者存在明顯的血小板型高凝狀態(tài),中重度活動(dòng)CD患者同時(shí)存在凝血因子高活性及血小板功能亢進(jìn)。CDAI評(píng)分及CRP可以作為預(yù)測(cè)CD患者發(fā)生凝血功能障礙的指標(biāo)。對(duì)于CD患者凝血功能的診斷,TEG檢查相較于凝血四項(xiàng)檢查更為敏感。
[Abstract]:Objective: to observe the changes of coagulation function in patients with Crohn's disease (CD) and discuss the risk factors. Methods: from June 2013 to December 2013, CD patients in our department and healthy volunteers in the same period as control group were included in the study. The following indexes were monitored: inflammatory activity index, ESRs, CDAI score, and blood routine examination. Routine coagulation and thromboelastography (TEG) were performed. According to the CDAI score, the patients were divided into two groups: group A (active phase A group) (moderate and severe active stage group B group (remission stage group C group), healthy control group). The changes of coagulation function among groups were compared, and the risk factors of coagulation function change were analyzed. Results: a total of 277 patients were included in the study, including 87 active and 87 remission. There was no significant difference in the four indexes of coagulation between the healthy control group (103 cases) and the healthy control group (P < 0.05). There was no significant difference in the R value and K value of the TEG parameter between the healthy control group and the healthy control group. In the healthy group, the 偽 value was significantly higher than that in the healthy control group. There was no significant difference in the value of K and K between the two groups, but there was no significant difference in the value of K and K in the patients with CD in remission stage. The increase of 偽 value was p0.05A; the value of K in patients with moderate and severe active CD was significantly lower than that in the healthy control group, which was significantly lower than that in the rest of the control group. The MA value and 偽 value of the group were significantly higher than those of the control group (p 0.05), but there was no significant difference in the EPL values of LY30 and LY30 among the groups (P 0.05). Multiple linear regression analysis showed that there was a positive correlation between the level of CRPPLT and MA value in CDAII, and the correlation between CDAI and 偽 value was positive correlation between CDAI and 偽 value. Conclusion there is hypercoagulant function in the patients with 1: CD, mainly manifested as platelet type hypercoagulability, coagulation factor activity, and fibrinolytic system. There was no obvious abnormality of coagulation function in patients with CD in remission stage, but there was obvious platelet hypercoagulability in patients with active CD. The high activity of coagulation factor and platelet hyperfunction. CDAI score and CRP can be used as predictors of coagulation dysfunction in patients with moderate and severe active CD. The diagnosis of coagulation function in CD patients was more sensitive to TEG than to the four tests of coagulation.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R574.62

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本文編號(hào)：1966327