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血管内皮损伤和血小板活化标志物对诊断缺血性结肠炎的临床价值

来源:用户上传      作者:朱华丽 阙扬铭 季霞 阮水良

  [摘要] 目的 探血管内皮损伤和血小板活化标志物对诊断缺血性结肠炎(IC)的临床价值。 方法 选取2019年12月至2020年12月入院接受治疗的58例疑似IC患者,包括30例IC患者(IC组)和28例溃疡性结肠炎(UC)患者(UC组);另选择同期行健康体检者30例为对照组。采用酶联免疫吸附试验测定外周血液中血管假性血友病因子(vWF)、血栓调节蛋白(TM)、内皮素-1(ET-1)、血小板活化因子(PAF)含量。流式细胞术检测血小板豢帕Dぬ堑鞍祝CD62p)和溶酶体膜蛋白(CD63)表达。 结果 IC组患者的血清vWF、TM、ET-1、PAF水平及血小板CD62p、CD63表达水平均高于对照组(P<0.05);且IC组患者血清vWF、TM、ET-1水平以及血小板CD62p、CD63表达水平亦高于UC组(P<0.05)。ROC曲线分析,血清vWF、TM、ET-1、PAF及血小板CD62p、CD63对IC的诊断效能较高(AUC均>0.8);血清vWF、TM及血小板CD62p对IC患者和UC患者的鉴别诊断效能也较高(AUC>0.08)。多肠段亚组IC患者血清TM、ET-1、PAF水平均高于单一肠段亚组患者(P<0.05)。 结论 检测血清vWF、TM、ET-1、PAF、血小板CD62p、CD63表达有助于IC患者的临床诊断。此外检测血清vWF、TM、血小板CD62p表达对IC患者和UC患者的鉴别诊断也有一定的参考价值。
  [关键词] 血管内皮损伤;血小板活化;缺血性结肠炎;溃疡性结肠炎
  [中图分类号] R574.6 [文献标识码] B [文章编号] 1673-9701(2022)13-0034-04
  [Abstract] Objective To investigate the clinical value of vascular endothelial injury and platelet activation markers in the diagnosis of ischemic colitis (IC). Methods A total of 58 patients with suspected IC who were admitted to our hospital from December 2019 to December 2020 were selected, including 30 patients with IC(IC group) and 28 patients with ulcerative colitis (UC)UC group. Another 30 healthy subjects in Second Hospital of Jiaxing in Zhejiang during the same period were selected as the control group. The levels of von Willebrand factor (vWF), thrombomodulin (TM), endothelin-1 (ET-1) and platelet activating factor (PAF) in peripheral blood were measured by enzyme-linked immunosorbent assay.Flow cytometry was used to detect the expression of Platelet granule membrane glycoprotein (CD62p) and lysosomal membrane protein (CD63). Results The serum vWF, TM, ET-1, PAF levels, and platelet CD62p and CD63 expression levels in the IC group were higher than those in the control group(P<0.05). The serum levels of vWF, TM, ET-1, and the platelet CD62p and CD63 expression levels in the IC group were also higher than those in the UC group(P<0.05).ROC curve analysis showed that serum vWF, TM, ET-1, PAF, and platelet CD62p,CD63 had higher diagnostic efficacy for IC (AUC>0.8 for all).The serum vWF,TM,and platelet CD62p also had higher differential diagnostic efficacy for IC and UC patients (AUC>0.08). The serum levels of TM, ET-1, and PAF in patients with polyenteric IC were higher than those in patients with a single intestinal segment(P<0.05). Conclusion Detection of serum vWF, TM, ET-1, PAF, platelet CD62p and CD63 expression is helpful for the clinical diagnosis of IC patients. In addition, the detection of serum vWF,TM,and platelet CD62p expression also has some reference value for the differential diagnosis of IC patients and UC patients.

nlc202206161041



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