Objective To study endothelial cell damage and changes of parameters related to coagulation and the anticoagulation function in patients with arthropathic psoriasis.Methods A total of 31 psoriasis vulgaris patients,29 arthropathic psoriasis patients and 60 normal controls were enrolled.Coagulation analyzer ALC 9000 was used to measure the parameters related to endothelial damage,coagulation and anticoagulation system in these patients and controls.The correlation between PASI and the tested parameters was assessed.Results Compared with the normal controls,decreased atithrombin activity as well as protein C activity and antigen were observed in 31 psoriasis vulgaris patients and 29 psoriasis arthropathic patients,whereas increased levels of plasminogen activator inhibitor-1 and vW factor were found in these patients.Patients with arthropathic psoriasis had higher levels of plasminogen activator inhibitor-1 and vW factor but a lower level of atithrombin activity as well as protein C activity and antigen than those with psoriasis vulgaris.There was no correlation between PASI and any of the tested parameters.Conclusion There is a more serious damage of endothelial cell in patients with arthropathic psoriasis than psoriasis vulgaris patients,which may lead to the attenuation of anticoagulation function and fibrinolysis activity.Arthropathic psoriasis patients may have a high risk of suffering cardiovascular disease under the background of the inflammation.%目的 研究关节病型银屑病患者血管内皮细胞的损伤情况和抗凝血、凝血功能参数的变化.方法 采用美国ILACL9000型血液凝固仪测定31例寻常型银屑病患者、29例关节病型银屑病患者和60例健康对照者的血管内皮、凝血及抗凝血各项指标并结合PASI值进行分析.结果 患者抗凝血酶活性(AT:A)、蛋白C活性(PC:A)、蛋白C抗原含量(PC:Ag)、纤溶酶原激活物抑制剂-1(PAI-1) PAI-1和vW因子(vWF)结果显示关节病型银屑病组和寻常型银屑病组AT:A、PC:A、AT:Ag、PC:Ag水平均低于对照组,PAI-1和vWF高于对照组,差异有统计学意义(P＜0.01).关节病型银屑病组AT:A、PC:A水平均低于寻常型银屑病组,PAI-1和vW F高于寻常型银屑病组,差异有统计学意义(P＜0.01).所检测参数指标未发现和PASI存在相关性.结论 关节病型银屑病存在相比寻常型银屑病更严重的血管内皮损伤及这种损伤导致的抗凝血及纤溶系统功能的降低,可能提示关节病型银屑病存在比寻常型银屑病更严重的炎症反应及合并心血管疾病的高风险性.
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