压力诱导的高凝血:从流行病学和机理学研究的见解,以及临床整合
1Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Seminars in thrombosis and hemostasis
|June 24, 2024
概括
压力会导致高凝血,增加心血管疾病和静脉血栓栓塞的风险. 这种最初适应性的状态在慢性压力下会变得有害,影响血栓形成的风险.
科学领域:
- 临床医学 临床医学
- 心血管科学 心血管科学
- 血液学 血液学 血液学
背景情况:
- 压力显著影响静血因素,可能导致高凝血状态.
- 前性队列研究将压力和高凝血性与心血管和静脉血栓栓塞性疾病的风险增加和不良预后联系起来.
- 门德尔的随机化研究表明,压力和高凝血能力之间存在部分因果关系.
研究的目的:
- 审查和综合关于急性和慢性压力与高凝血能力之间的联系的研究.
- 概述从压力到血栓形成风险的潜在途径,考虑适应性和不适应性反应.
- 探索压力诱导的高凝固性背后的神经内分泌,细胞和分子机制.
主要方法:
- 综合综合审查,元分析和遗传学研究的发现.
- 对前性队列研究和门德尔随机化研究的分析.
- 关于神经内分泌,细胞和分子机制的研究综合.
主要成果:
- 压力诱导的高凝血性与动脉样硬化心血管疾病和静脉血栓栓塞的风险增加和预后不佳有关.
- 在慢性或过度的压力下,急性压力诱导的高凝血能力可能变得不适应,导致血栓事件.
- 神经内分泌通路 (交感神经系统,HPA轴) 和诸如甲基荷胺,皮质醇和血管压素等因素是压力诱导的高凝血的核心.
结论:
- 压力诱导的高凝血在临床医学中起着重要作用,影响血栓形成风险.
- 需要进一步的研究来确定慢性压力和高凝血能力之间的确切因果关系.
- 了解这些机制对于开发应激个体中血栓性疾病的干预措施至关重要.
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