Buriachkovskaia L I, Poliakova E O, Zorin A V, Uchitel' I A, Dovlatova N L, Masenko V P, Sumarokov A B, Kadushina E B, Kuzentsova T A, Pogorelova T E, Chazov E I
Ter Arkh. 2006;78(10):9-14.
To study morphological features and functional activity of platelets, their relations with the level of inflammation markers in coronary heart disease (CHD) patients with depression.
The study group consisted of 33 CHD patients with stable effort angina (NY-HA FC I-III), 14 had depression, 19 were free of depression. Sixteen healthy volunteers comprised the control group. Platelet aggregation was registered by a mean size of aggregates and turbidometrically. Platelets shape, leukocytic-thrombocytic and erythrocytic-thrombocytic aggregates (LTA, ETA) in the whole blood were studied electron-microscopically. The levels of IL-2, IL-6, TNF-alpha, sVCAM, hsCRP were measured in the blood, serotonin--in platelets.
Spontaneous aggregation enhanced in 52.6% CHD patients (p < 0.05). The blood contained reticular platelets, high number of prothrombocytes (p < 0.05), mean volume of thrombocytes was greater (p < 0.05). This reflected changes in megakaryocytopoiesis. Some of the patients had LTA and ETA. Out of inflammation markers, only IL-6 and sVCAM were elevated (p < 0.01), hsCRP concentration rose, but not above normal range. Serotonin in platelets was the same in the patients and controls. Depression aggravated the disorders and elevated other indices. Spontaneous aggregation was high in 71.4% of depressive CHD patients. The count of reticular platelets, prothrombocytes, mean volume platelets were also elevated. LTA and ETA were high in all the depressive patients. Elevated were also concentrations of IL-6, sVCAM, IL-2, hsCRP. Serotonin in platelets was low (p < 0.05).
Depression stimulates functional activity of platelets, is a factor of risk of intravascular inflammation and contributes to development of thrombotic complications in CHD patients.
研究冠心病（CHD）伴抑郁症患者血小板的形态特征和功能活性，以及它们与炎症标志物水平的关系。
研究组由33例稳定型劳力性心绞痛（NY-HA FC I-III）的CHD患者组成，其中14例患有抑郁症，19例无抑郁症。16名健康志愿者组成对照组。通过聚集物的平均大小和比浊法记录血小板聚集情况。采用电子显微镜研究全血中血小板的形态、白细胞-血小板和红细胞-血小板聚集体（LTA、ETA）。检测血液中IL-2、IL-6、TNF-α、sVCAM、hsCRP的水平，以及血小板中的5-羟色胺水平。
52.6%的CHD患者自发性聚集增强（p<0.05）。血液中存在网状血小板，原血小板数量较多（p<0.05），血小板平均体积更大（p<0.05）。这反映了巨核细胞生成的变化。部分患者存在LTA和ETA。在炎症标志物中，只有IL-6和sVCAM升高（p<0.01），hsCRP浓度升高，但未超出正常范围。患者和对照组血小板中的5-羟色胺水平相同。抑郁症加重了这些紊乱并使其他指标升高。71.4%的抑郁CHD患者自发性聚集较高。网状血小板、原血小板数量、血小板平均体积也升高。所有抑郁患者的LTA和ETA均较高。IL-6、sVCAM、IL-2、hsCRP的浓度也升高。血小板中的5-羟色胺水平较低（p<0.05）。
抑郁症刺激血小板的功能活性，是血管内炎症风险因素，有助于CHD患者血栓并发症的发生。
