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P179 Changes in the haemostatic system in patients with ulcerative colitis depending on the degree of activity of the disease

O. Knyazev*1, A. Kagramanova1, A. Lishchinskaya1, G. Dudina2, V. Subbotin3, K. Noskova4, A. Parfenov1

1Moscow Clinical Scientific Center named after A. S. Loginov, Department of inflammatory bowel diseases, Moscow, Russian Federation, 2Moscow Clinical Scientific Center named after A. S. Loginov, Department of Hematology, Moscow, Russian Federation, 3Moscow Clinical Scientific Center named after A. S. Loginov, Department of anesthesiology and resuscitation, Moscow, Russian Federation, 4Moscow Clinical Scientific Center named after A. S. Loginov, Department of laboratory diagnostics, Moscow, Russian Federation

Background

Patients with inflammatory bowel disease (IBD) showed more frequent development of thromboembolic complications, compared with the general population. The aim was to identify changes in the haemostatic system in patients with ulcerative colitis (UC), depending on the degree of activity of the disease.

Methods

The study included 15 patients with total lesions, who were divided into three groups, depending on the degree of activity of the disease on the Mayo scale. The first group of patients was in remission, the second group of patients with UC had moderate activity of the disease, the third group was in high activity. The state of the blood coagulation system of the patients was assessed by the method of extended coagulogram (INR, APTT, prothrombin, antithrombin III, protein S) and using the method of thromboelastography (TEG). Patients were excluded hereditary coagulopathy.

Results

In all three groups of patients with UC, according to the extended coagulogram, no changes in the indicators typical for the disorders of the blood coagulation system were revealed.

According to the TEG data in Group 1, the time from the beginning of clot formation to the achievement of a fixed level of clot strength (amplitude = 20 mm) (K) was on average 3.7 min, an increase in the angle built tangentially to the thromboelastogram from the point of clot formation (angle) to 48.9, the maximum amplitude characterising the maximum dynamic properties of the fibrin and platelets compound by GPIIb/IIIa receptors (MA) to 57.9 mm.

In the second group, the time from the beginning of clot formation to the achievement of a fixed level of clot strength (amplitude = 20 mm) (K) was on average 2.45 min, an increase in the angle built tangentially to the thromboelastogram from the point of clot formation (angle) to 58.9, the maximum amplitude characterising the maximum dynamic properties of the fibrin and platelet compounds by GPIIb/IIIa receptors (MA) to 63.05 mm. In Group 3, the time from the beginning of clot formation to the achievement of a fixed level of clot strength (amplitude = 20 mm) (K) was on average 2.92 min, an increase in the angle built tangentially to the thromboelastogram from the point of clot formation (angle) to 63.9, the maximum amplitude characterising the maximum dynamic properties of the fibrin and platelets compound by GPIIb/IIIa receptors (MA) to 71.24 mm.

Conclusion

The thromboelastography is a more sensitive method for detecting haemostatic disorders in patients with UC, compared with a standard coagulogram. According to thromboelastography in patients with ulcerative colitis there is a hypercoagulation state of the blood system, regardless of the activity of the inflammatory process. The degree of hypercoagulation increases with the activity of the disease.