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目的探讨炎症性肠病中凝血异常与炎症的关系。方法检测三硝基苯磺酸钠(trinitro-benzene-sulfonic acid TNBS)灌肠诱导大鼠结肠炎模型中的凝血指标明确有无凝血异常。将30只SD大鼠分为三组,(1)正常对照组:仅用生理盐水灌肠。(2)结肠炎1周组,TNBS灌肠1周后处死,模拟结肠炎中的急性炎症期。(3)结肠炎2周组:TNBS灌肠2周后处死,模拟慢性炎症期。处死后取血检查凝血酶原时间(prothrombin time PT)、活化部分凝血激酶时间(activated partial thromboplastin time APTT)、血小板计数以及抗凝血酶活性(antithrombin AT)。处死同时检查组织损伤和炎症水平指标。结果TNBS诱导的结肠炎模型中凝血酶原时间、活化部分凝血激酶时间均较正常对照组为短;抗凝血酶活性较正常对照组下降,血小板数目较对照组升高。差异均有统计学意义(P<0.05)。通过相关分析,组织损伤以及炎症指标和PT、APTT以及抗凝血酶活性成负相关(P<0.01),与血小板计数成正相关。结论TNBS诱导的结肠炎模型中存在凝血异常,且与病情严重程度有相关性。提示临床上的炎症性肠病中存在凝血异常和炎症活动水平关系紧密。本模型可以作为炎症激活凝血异常的模型来研究这一现象。
Objective To investigate the relationship between coagulation abnormalities and inflammation in inflammatory bowel disease. Methods The coagulation index in the model of colitis induced by enema of trinitro-benzene-sulfonic acid (TNBS) in rats was determined with or without coagulation abnormalities. 30 SD rats were divided into three groups, (1) normal control group: saline only enema. (2) Colitis 1 week group, TNBS enema was sacrificed after 1 week, simulating acute inflammation in colitis. (3) Colitis 2 weeks group: TNBS enema was sacrificed 2 weeks later to simulate the chronic inflammatory phase. Prostrombin time (PT), activated partial thromboplastin time (APTT), platelet count and antithrombin AT were determined after sacrifice. Execute at the same time check the level of tissue damage and inflammation indicators. Results The prothrombin time and activated partial thromboplastin time in TNBS-induced colitis model were both shorter than those in normal control group. The antithrombin activity was lower than that in normal control group and the number of platelets was higher than that in control group. The differences were statistically significant (P <0.05). Correlation analysis showed that there was a negative correlation between tissue damage and inflammation index, PT, APTT and antithrombin activity (P <0.01), and positively correlated with platelet count. Conclusion There is coagulation abnormality in TNBS-induced colitis model, which is related to the severity of the disease. Prompt clinical inflammatory bowel disease in the existence of coagulation abnormalities and inflammatory activity levels are closely related. This model can be used as a model of inflammatory activation of coagulation abnormalities to study this phenomenon.