Brydon Lena, Magid Kesson, Steptoe Andrew
The Psychobiology Group, Department of Epidemiology and Public Health, University College London, London, UK.
Brain Behav Immun. 2006 Mar;20(2):113-9. doi: 10.1016/j.bbi.2005.08.002. Epub 2005 Sep 23.
Coronary heart disease is the leading cause of death in Western society, and its development is associated with chronic stress and other psychosocial factors. Atherosclerosis, the disorder underlying this disease, is an inflammatory process in which leukocytes interact with structurally intact but dysfunctional endothelium of the arteries. Platelets play a key role in this process by binding to leukocytes and promoting their recruitment to the endothelium. Platelet-leukocyte interactions also stimulate the release of pro-inflammatory and pro-thrombotic factors which promote atherosclerosis. Elevated circulating levels of platelet-leukocyte aggregates have been reported in cardiac patients and in individuals of low socioeconomic status, a factor associated with chronic psychological stress. Increased platelet activation has also been observed in individuals prone to depression or hostility, and in people subject to high levels of work stress. Acute psychological stress increases circulating platelet-leukocyte aggregates in healthy individuals and this effect is prolonged in cardiac patients. Platelet activation may be a mechanism linking psychosocial stress with increased coronary risk, and may also play a role in the emotional triggering of acute coronary syndromes in patients with advanced coronary disease.
冠心病是西方社会的主要死因，其发展与慢性应激及其他社会心理因素相关。动脉粥样硬化是该疾病的潜在病症，是一种炎症过程，其中白细胞与结构完整但功能失调的动脉内皮相互作用。血小板在这一过程中起关键作用，通过与白细胞结合并促进其向内皮募集。血小板 - 白细胞相互作用还会刺激促炎和促血栓形成因子的释放，从而促进动脉粥样硬化。据报道，心脏病患者和社会经济地位较低的个体（与慢性心理应激相关的一个因素）的循环血小板 - 白细胞聚集体水平升高。在易患抑郁症或敌意的个体以及承受高水平工作压力的人群中也观察到血小板活化增加。急性心理应激会增加健康个体的循环血小板 - 白细胞聚集体，而这种效应在心脏病患者中会持续更长时间。血小板活化可能是将社会心理应激与冠心病风险增加联系起来的一种机制，并且可能在晚期冠心病患者急性冠状动脉综合征的情绪触发中也起作用。
