nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-234-2-163-171nogr-3083Research ArticleОБЗОРREVIEWТромбообразование при воспалительных заболеваниях кишечника: роль факторов риска, маркеры, методы диагностики и направления будущих исследованийThrombus formation in inflammatory bowel diseases (IBD): the role of risk factors, markers, diagnostic methods and directions for future researchhttps://orcid.org/0000-0002-2436-3813ФоминыхЮ. А.FominykhYu. A.noemail@neicon.ruhttps://orcid.org/0000-0002-0734-0791БернгардтЭ. Р.BerngardtE. R.noemail@neicon.ruhttps://orcid.org/0000-0001-5129-9944ГалагудзаМ. М.GalagudzaM. M.noemail@neicon.ruhttps://orcid.org/0009-0005-9951-2931МайороваА. М.MayorovaA. M.annamajorova@mail.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России; Федеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research Centre of the Ministry of Health of the Russian Federation; St. Petersburg State Pediatric Medical UniversityRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research Centre of the Ministry of Health of the Russian FederationRussian Federation20253108202502163171Copyright © Фоминых Ю.А., Бернгардт Э.Р., Галагудза М.М., Майорова А.М., 20252025Фоминых Ю.А., Бернгардт Э.Р., Галагудза М.М., Майорова А.М.Fominykh Y.A., Berngardt E.R., Galagudza M.M., Mayorova A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/3083

В работе проведён анализ патогенетических механизмов тромбообразования при воспалительных заболеваниях кишечника (ВЗК). Обсуждаются основные процессы, приводящие к активации коагуляционного каскада, включая хроническое воспаление, эндотелиальную дисфункцию и иммунологические реакции, способствующие развитию тромбозов. Особое внимание уделено таким факторам риска, как генетическая предрасположенность, сопутствующие заболевания и особенности патогенеза ВЗК. Также рассмотрено влияние препаратов, применяемых для лечения ВЗК, включая глюкокортикостероиды, иммуносупрессоры и биологические препараты. Оценено, как лекарственная терапия может изменять профили риска тромбообразования и влиять на прогноз пациента. Представлен анализ современных диагностических маркеров: D-димер, микровезикулы, микроРНК и других, а также методы оценки риска, способствующие диагностике и своевременной профилактике. Обращено внимание на использование антикоагулянтов у пациентов с ВЗК, как на важное направление профилактики и лечения тромбоэмболических осложнений (ТЭО). В заключении предложен ряд возможных направлений для будущих исследований: выявление биомаркеров, создание современных алгоритмов оценки риска и оптимизация лечебных стратегий при ВЗК с целью профилактики ТЭО и улучшения качества жизни пациентов.

This article analyzes the pathogenetic mechanisms of thrombus formation in inflammatory bowel diseases (IBD). The main processes leading to the activation of the coagulation cascade are discussed, including chronic inflammation, endothelial dysfunction, and immunomodulatory reactions that contribute to the development of thrombosis. The study pays special attention to risk factors such as genetic predisposition, comorbidities, and features of the pathogenesis of IBD. It also considers the effect of drugs used to treat IBD, including glucocorticosteroids, immunosuppressants, and biological drugs. It evaluates how drug therapy can change thrombus risk profiles and worsen the patient’s prognosis. In addition, the article analyzes modern diagnostic markers, including not only D-dimer, but also microvesicles, microRNA, and many other coagulation indicators. Existing risk assessment scales are presented that facilitate diagnosis and timely adoption of preventive measures. Attention is also drawn to anticoagulant therapy in patients with IBD as an important area for the prevention and treatment of thromboembolic complications. In conclusion, a number of possible directions for future research are proposed aimed at identifying new biomarkers, creating more accurate risk scales, and optimizing treatment strategies for IBD in order to reduce the likelihood of thrombotic complications and improve the quality of life of patients.

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The authors declare that there are no conflicts of interest present.