Grignani G, Pacchiarini L, Zucchella M, Tacconi F, Canevari A, Soffiantino F, Tavazzi L
Department of Internal Medicine, University of Pavia, IRCCS Policlinico S. Matteo, Italy.
Haemostasis. 1992;22(3):138-46. doi: 10.1159/000216310.
We studied the effect of emotional stress (mental arithmetic for 10 min) in 10 postinfarction patients and in 10 age-matched apparently healthy subjects as controls. Blood samples for platelet function studies and for the determination of epinephrine levels in serum were taken in basal conditions, at the end of mental stress and after 30 min of recovery. Patients were studied twice, in washout of medications and after oral administration of dipyridamole, 200 mg twice a day for 6 consecutive days. Mental stress induced in patients significant increments in different hemodynamic parameters (heart rate, systolic blood pressure and diastolic blood pressure) and in serum epinephrine levels. Concomitantly, the test produced a significant increase in platelet aggregation (induced by 3 microM ADP or 1 microgram/ml collagen), the formation of circulating platelet aggregates and an increase in plasma thromboxane B2 levels. Hemodynamic parameters and platelet function tests returned to baseline values after 30 min. Similar activation of hemodynamic parameters, similar increase in epinephrine levels and lower increase in platelet function by emotional stress were observed in control subjects. Treatment of patients with dipyridamole had no effect on stress-induced increase in hemodynamic parameters and epinephrine levels, but decreased stress-related platelet activation. These data can contribute to a better understanding of the complex relationships between psychosocial factors, the hemostatic system and vascular disease.
我们研究了情绪应激（10分钟心算）对10名心肌梗死后患者以及10名年龄匹配的明显健康受试者（作为对照）的影响。在基础状态下、精神应激结束时以及恢复30分钟后，采集血样用于血小板功能研究和血清肾上腺素水平测定。患者接受了两次研究，一次是在停用药物后，另一次是在口服双嘧达莫（每天两次，每次200毫克，连续6天）之后。精神应激使患者的不同血流动力学参数（心率、收缩压和舒张压）以及血清肾上腺素水平显著升高。与此同时，该测试使血小板聚集（由3微摩尔/升二磷酸腺苷或1微克/毫升胶原诱导）显著增加、循环血小板聚集体形成以及血浆血栓素B2水平升高。30分钟后，血流动力学参数和血小板功能测试恢复到基线值。在对照受试者中观察到了类似的血流动力学参数激活、肾上腺素水平类似升高以及情绪应激导致的血小板功能较低程度的升高。用双嘧达莫治疗患者对应激诱导的血流动力学参数和肾上腺素水平升高没有影响，但降低了与应激相关的血小板激活。这些数据有助于更好地理解心理社会因素、止血系统和血管疾病之间的复杂关系。
