大疱性类天疱疮患者凝血系统的变化及其影响因素的分析  

Coagulation changes with bullous pemphigoid and their influencing factors

作　　者：封梦荻 徐有谋 王文氢[1] FENG Mengdi;XU Youmou;WANG Wenqing(Department of Dermatology,The Fourth Hospital of Hebei Medical University,Shijiazhuang050011,China)

机构地区：[1]河北医科大学第四医院皮肤科,河北石家庄050011 [2]北医科大学第一医院皮肤科,河北石家庄050031

出　　处：《临床皮肤科杂志》2024年第6期334-338,共5页Journal of Clinical Dermatology

摘　　要：目的:探讨大疱性类天疱疮(BP)患者局部和全身凝血系统的变化及其影响因素。方法:收集初次确诊的89例BP患者及同期在本院体检的89例健康成年人作为研究对象,比较两组的D二聚体(D-Dimer,D-D)和纤维蛋白(原)降解产物(FDP)水平,比较BP患者D-D和FDP水平差异。结果:BP患者D-D和FDP水平均高于对照组(P<0.05);与无高血压或心脑血管疾病及静脉血栓栓塞症的BP患者比较,并发上述疾病的患者D-D和FDP水平差异均无统计学意义(P>0.05);Spearman相关性分析显示D-D、FDP与C反应蛋白(CRP)、外周血嗜酸性粒细胞(EOS)计数、抗BP180 IgG抗体及BP面积指数评分(BPDAI)呈正相关(P<0.05),而与嗜酸性粒细胞阳离子蛋白(ECP)、抗BP180 IgE抗体及总IgE抗体无相关性(P>0.05);免疫组化示大量EOS浸润的BP组组织因子(TF)表达评分高于少量EOS浸润的BP组和对照组,少量EOS浸润BP组TF表达评分也高于对照组(P<0.05)。结论:BP患者局部和全身的凝血系统被激活,与BPDAI、外周血和组织EOS计数、血清抗BP180 IgG抗体及CRP有关,而与是否并发高血压、心脑血管疾病、静脉血栓栓塞症,以及血清ECP、抗BP180 IgE抗体及总IgE抗体无关;血浆D-D、FDP可能是评估BP严重程度的潜在指标。Objectives:To explore the changes in the local and systemic coagulation systems of patients with bullous pemphigoid and influencing factors.Methods:A total of 89 BP patients who were initially diagnosed and 89 healthy adults who were examined in our hospital during the same period were collected as research subjects.The levels of D-Dimer and fibrinogen degradation product in two groups were compared.The levels of D-D and FDP in BP patients were compared.Results:The levels of D-D and FDP in BP patients were higher than those in the control group(P<0.05).There were no significant differences in D-D and FDP levels between BP patients with or without hypertension or cardiovascular and cerebrovascular diseases and venous thromboembolism(P>0.05).Spearman correlation analysis showed positive correlation between D-D,FDP and CRP,EOS count,anti-BP180 IgG antibody,and BPDAI(P<0.05),but no significant correlation with ECP,anti-BP180 IgE antibody,and total IgE antibody(P>0.05).Immunohistochemistry showed that the TF expression score in the BP group with a large number of infiltrating EOS was higher than that in the BP group with a small amount of infiltrating EOS and the NC group,and the TF expression score of the BP group with a small amount of EOS infiltration was higher than that in the control group(P<0.05).Conclusion:The local and systemic coagulation systems of BP patient were activated,which was related to BPDAI,peripheral blood and tissue EOS count,serum anti-BP180 IgG antibody and CRP,but not to hypertension,cardiovascular and cerebrovascular diseases,venous thromboembolism,serum ECP,anti-BP180 IgE antibody,and total IgE antibody.And plasma D-D and FDP may be potential indicators to assess the severity of BP.

关 键 词：大疱性类天疱疮 凝血 D二聚体 纤维蛋白原降解产物 组织因子 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]