应激与血栓形成研究进展

Progress of research in stress and thrombosis

凝血反应作为急性应激反应的一种,受到社会因素、精神因素及并发疾病等多因素影响。大量的研究已经证实,机体针对精神应激的凝血反应可以导致血液的高凝状态,进而防止受伤部位的失血过多。在患有冠状动脉粥样硬化的患者中,长时间或过度应激导致的血液持续高凝状态可能会促进冠状动脉内的斑块破裂,加速血栓的形成。急性应激不仅可以作为血栓形成的高危因素,它还可引起静脉血栓栓塞的发生。下丘脑-垂体-肾上腺轴和自主神经系统在长时程应激反应中参与了对止血反应和血栓形成的调节。此外,除了交感神经系统的激活以外,高级认知脑区和皮质边缘脑区对应激信息的评估在应激致血栓形成中发挥了关键的作用。

The blood coagulation reaction, as a kind of acute stress reactions, affected by impacts of social factors, psy- chological factors and concurrent disease etc. A large number of studies have confirmed that the blood clotting of the body response to mental stress can lead to high blood coagulation state, thus prevent the injured area bleeding. In pa- tients with coronary atherosclerosis, a long time or excessive stress caused by continuous high blood coagulation state can promote plaque rupture in coronary artery and accelerate the formation of blood clots. Acute stress can not only run as risk factors of thrombosis, it also lead to the occurrence of venous thromboembolism. The hypothalamus-pituitary-a- drenal axis and autonomic nervous system are involved in regulating of hemostasis and thrombosis during the long-time stress reaction. In addition to the activation of the sympathetic nervous system, the stress information assessment by ad- vanced cognitive brain arias and timbic cortex of brain regions plays a key role in thrombosis.