von Känel Roland, Kudielka Brigitte M, Preckel Daniel, Hanebuth Dirk, Herrmann-Lingen Christoph, Frey Karl, Fischer Joachim E
Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital Berne, Switzerland.
Physiol Behav. 2005 Sep 15;86(1-2):61-8. doi: 10.1016/j.physbeh.2005.06.005.
Exaggerated procoagulant responses to acute mental stress may contribute to coronary thrombosis, and continuing low-grade systemic coagulation activation may link negative affect with the development of coronary artery disease. We investigated whether negative and positive affect and perceived social support would moderate stress procoagulant reactivity. Psychological functioning, exhaustion, negative affectivity, depression, anxiety, worrying, vigor, and social support were assessed in 27 apparently healthy men (mean age 47 +/- 8 years) who underwent the 13-min Trier Social Stress Test combining preparation, speech, and mental arithmetic. Plasma levels of von Willebrand factor antigen (VWF:Ag), fibrinogen, factor VII clotting activity (FVII:C), FVIII:C, FXII:C, and D-dimer were measured immediately before and after stress. Acute stress elicited significant increases in hemodynamic, cortisol, and coagulant activity (p values < 0.05). VWF:Ag reactivity showed inverse relationships with exhaustion (r = -0.63, p < 0.001), negative affectivity (r = -0.53, p = 0.005), and worrying (r = -0.53, p = 0.005). Exhaustion and negative affectivity emerged as independent predictors of VWF:Ag reactivity explaining 54% of its variance. Fibrinogen reactivity showed inverse relationships with negative affectivity (r = -0.59, p = 0.002) and anxiety (r = -0.54, p = 0.005); negative affectivity emerged as an independent predictor of fibrinogen reactivity explaining 35% of its variance. Psychological functioning and FVII:C reactivity were also correlated (r = -0.52, p = 0.006). Whereas FVIII:C reactivity correlated positively with vigorous mood (r = 0.48, p = 0.012), positive associations between social support and procoagulant reactivity did not reach significance. Negative affect was associated with attenuated procoagulant reactivity to stress and the opposite was observed for positive affect. Negative affect is not likely to enhance the acute procoagulant stress response in healthy men.
对急性精神压力的过度促凝反应可能会导致冠状动脉血栓形成,而持续的低度全身凝血激活可能会将负面影响与冠状动脉疾病的发展联系起来。我们研究了消极和积极情绪以及感知到的社会支持是否会调节应激促凝反应性。对27名明显健康的男性(平均年龄47±8岁)进行了心理功能、疲惫、消极情感、抑郁、焦虑、担忧、活力和社会支持的评估,这些男性接受了包括准备、演讲和心算的13分钟特里尔社会应激测试。在应激前后立即测量血浆血管性血友病因子抗原(VWF:Ag)、纤维蛋白原、凝血因子VII凝血活性(FVII:C)、FVIII:C、FXII:C和D-二聚体水平。急性应激引起血流动力学、皮质醇和凝血活性显著增加(p值<0.05)。VWF:Ag反应性与疲惫(r = -0.63,p < 0.001)、消极情感(r = -0.53,p = 0.005)和担忧(r = -0.53,p = 0.005)呈负相关。疲惫和消极情感成为VWF:Ag反应性的独立预测因素,解释了其54%的变异。纤维蛋白原反应性与消极情感(r = -0.59,p = 0.002)和焦虑(r = -0.54,p = 0.005)呈负相关;消极情感成为纤维蛋白原反应性的独立预测因素,解释了其35%的变异。心理功能和FVII:C反应性也相关(r = -0.52,p = 0.006)。而FVIII:C反应性与活力情绪呈正相关(r = 0.48,p = 0.012),社会支持与促凝反应性之间的正相关未达到显著水平。消极情绪与对应激的促凝反应减弱有关,而积极情绪则相反。消极情绪不太可能增强健康男性的急性促凝应激反应。