溃疡性结肠炎伴继发性血小板增多症一例并文献复习

One Case of Ulcerative Colitis with Secondary Thrombocytosis and Literature Review

摘要: 溃疡性结肠炎(UC)是一种病因不明的慢性肠道内炎症，随着生活水平的进步和环境污染的加重，UC的发病率较前大幅提高，大多患者腹痛、便血症状明显，严重影响了正常生活，已演变成一种全球性的负担。尽管目前内镜及组织学检查已经普及，诊断方式简单，治疗指南明确，但仍有相当一部分患者对药物治疗的反应不明显，极大地影响了患者的生活质量。所以在临床工作中对患者进行全面检查，多方面分析，减少误诊、实施个体化治疗显得尤为重要。最近我们接诊了一名溃疡性结肠炎伴血小板增多的患者，院外进行传统的溃结治疗效果不明显，在我院进行降血小板治疗后临床症状改善明显，血小板除了有止血作用，还作为传统的抗炎细胞在炎症性肠病中发挥作用，因此控制血小板数量也可有效控制肠道炎症的发展。此篇通过对我科收治的1例溃疡性结肠炎合并血小板增多症患者的诊治过程进行回顾性分析并文献复习，讨论异常血小板活化对肠道炎症的影响，考虑调节血小板治疗溃疡性结肠炎的潜在益处，为今后的治疗提供新的思路。

Abstract: Ulcerative colitis (UC) is a chronic intestinal inflammation with unknown etiology. With the im-provement of living standards and the aggravation of environmental pollution, the incidence of UC has increased significantly. Most patients have obvious symptoms of abdominal pain and blood in the stool, which seriously affects their normal life and has become a global burden. Although en-doscopy and histology have been widely used, with simple diagnostic methods and clear treatment guidelines, quite a few patients still do not respond significantly to drug therapy, which greatly af-fects the quality of life of patients. Therefore, in clinical work, it is particularly important to conduct comprehensive examination of patients, analyze in many aspects, reduce misdiagnosis and imple-ment individualized treatment. Recently, we received a patient with ulcerative colitis accompanied by thrombocytosis. The effect of traditional ulcerative colitis treatment outside the hospital was not obvious, but the clinical symptoms improved significantly after the treatment of platelet lowering in our hospital. In addition to their role in hemostasis, platelets also play a role as traditional an-ti-inflammatory cells in inflammatory bowel disease, so controlling platelet count can also effective-ly control the development of intestinal inflammation. Controlling platelet count can also effectively control the development of intestinal inflammation. This paper retrospectively analyzed the diag-nosis and treatment process of a patient with ulcerative colitis complicated with thrombocytosis admitted to our department and reviewed the literature, discussed the influence of abnormal platelet activation on intestinal inflammation, considered the potential benefits of platelet regula-tion in the treatment of ulcerative colitis, and provided new ideas for future treatment.