止血的时间生物学以及对凝血障碍的时间治疗和血栓形成预防的推断。

Chronobiology of hemostasis and inferences for the chronotherapy of coagulation disorders and thrombosis prevention.

作者信息

Haus Erhard

机构信息

University of Minnesota, HealthPartners Medical Group, Regions Hospital, St. Paul 55101, USA.

出版信息

Adv Drug Deliv Rev. 2007 Aug 31;59(9-10):966-84. doi: 10.1016/j.addr.2006.11.002. Epub 2007 Jul 5.

DOI:10.1016/j.addr.2006.11.002

PMID:17822804

Abstract

The hemostatic system in its multiple components displays an intricate organization in time which is characterized by circadian (approximately 24-hour), circaseptan (approximately 7-day), menstrual (approximately monthly), and circannual (approximately yearly) bioperiodicities. The interaction of the rhythms of the variables participating in hemostasis determine transient risk states of thromboembolic events, including myocardial infarction and stroke, and of hemorrhage and hemorrhagic events, each with a unique timing. The circadian staging of the rhythms in vascular, cellular, and coagulation factors that favors blood coagulation and thrombosis coincides with the daily minimum in fibrinolytic activity; as a result there is elevated risk in the morning of acute myocardial infarction and stroke. Similar hemostatic rhythms may determine the epidemiology of thromboembolic and hemorrhagic events during the week, month and year. This article focuses on the large-amplitude circadian rhythms operative in the hemostatic system. Their implication for preventive and curative pharmacotherapy of hemostatic disorders is presented, with discussion of related problems.

摘要

止血系统的多个组成部分在时间上呈现出复杂的组织形式，其特点是具有昼夜（约24小时）、周（约7天）、月经（约每月）和年（约每年）生物节律。参与止血的各种变量的节律相互作用，决定了血栓栓塞事件（包括心肌梗死和中风）以及出血和出血性事件的短暂风险状态，每种情况都有独特的时间规律。血管、细胞和凝血因子节律的昼夜分期有利于血液凝固和血栓形成，这与纤维蛋白溶解活性的每日最低值相吻合；因此，急性心肌梗死和中风在早晨的风险会升高。类似的止血节律可能决定一周、一个月和一年中血栓栓塞和出血事件的流行病学情况。本文重点关注止血系统中起作用的大幅度昼夜节律。文中介绍了它们对止血障碍预防和治疗药物疗法的影响，并讨论了相关问题。