Characteristics of Hemorheology in Patients with Acute Severe Ulcerative Colitis and the Clinical Study of Rivaroxaban Anticoagulant Therapy

Objectives: The present study aimed to determine the hemorheological characteristics of patients with acute severe ulcerative colitis (ASUC) and the effect of rivaroxaban anticoagulation therapy. The study also aimed to further explore the mechanisms and novel pathways underlying ASUC therapy. Methods: Various hemorheology tests were performed on 88 hospitalized ASUC patients, including mean platelet volume (MVP), platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) D-dimer and indicators of thrombelastogram (TEG). All results were compared with those of 40 colonic polyp controls. The ASUC patients were randomly divided into control and treatment groups (n = 44 each). The control group received routine mesalazine and methylprednisolone therapy, while the treatment group received rivaroxaban in addition to routine medicines. Montreal classification was used to evaluate the lesion range and the Mayo scoring system was used to evaluate the activity and treatment efficacy of the disease. The Endoscopic Severity Index of Ulcerative Colitis (UCEIS) was used to evaluate mucosal inflammation and Geboes index was used to evaluate mucosa histology. The percentage of microthrombus in pathological sections was calculated via immunohistochemical staining. The two groups were compared for efficacy, side effects, microthrombosis and hemorrheology after 30 days. Results and Conclusions: The results revealed that hypercoagulation is an important pathological stage of ASUC. Rivaroxaban anticoagulant therapy added to routine treatment was more effective than conventional treatment alone, which significantly improved the blood coagulation status of patients, alleviated clinical symptoms, relieved the endoscopic and histological outcomes, reduced the required hormone dosage and were worthy of clinical promotion.