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急性心理社会应激前后,社会支持水平较低与凝血活性较高之间存在独立关联。

Independent association between lower level of social support and higher coagulation activity before and after acute psychosocial stress.

作者信息

Wirtz Petra H, Redwine Laura S, Ehlert Ulrike, von Känel Roland

机构信息

Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.

出版信息

Psychosom Med. 2009 Jan;71(1):30-7. doi: 10.1097/PSY.0b013e31818f6868. Epub 2009 Jan 5.

Abstract

OBJECTIVE

To investigate the relationship between social support and coagulation parameter reactivity to mental stress in men and to determine if norepinephrine is involved. Lower social support is associated with higher basal coagulation activity and greater norepinephrine stress reactivity, which in turn, is linked with hypercoagulability. However, it is not known if low social support interacts with stress to further increase coagulation reactivity or if norepinephrine affects this association. These findings may be important for determining if low social support influences thrombosis and possible acute coronary events in response to acute stress. We investigated the relationship between social support and coagulation parameter reactivity to mental stress in men and determined if norepinephrine is involved.

METHODS

We measured perceived social support in 63 medication-free nonsmoking men (age (mean +/- standard error of the mean) = 36.7 +/- 1.7 years) who underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience. We measured plasma D-dimer, fibrinogen, clotting Factor VII activity (FVII:C), and plasma norepinephrine at rest as well as immediately after stress and 20 minutes after stress.

RESULTS

Independent of body mass index, mean arterial pressure, and age, lower social support was associated with higher D-dimer and fibrinogen levels at baseline (p < .012) and with greater increases in fibrinogen (beta = -0.36, p = .001; DeltaR(2) = .12), and D-dimer (beta = -0.21, p = .017; DeltaR(2) = .04), but not in FVII:C (p = .83) from baseline to 20 minutes after stress. General linear models revealed significant main effects of social support and stress on fibrinogen, D-dimer, and norepinephrine (p < .035). Controlling for norepinephrine did not change the significance of the reported associations between social support and the coagulation measures D-dimer and fibrinogen.

CONCLUSIONS

Our results suggest that lower social support is associated with greater coagulation activity before and after acute stress, which was unrelated to norepinephrine reactivity.

摘要

目的

研究男性社会支持与凝血参数对精神应激反应性之间的关系,并确定去甲肾上腺素是否参与其中。较低的社会支持与较高的基础凝血活性以及更强的去甲肾上腺素应激反应性相关,而这反过来又与高凝状态有关。然而,尚不清楚低社会支持是否与应激相互作用以进一步增加凝血反应性,或者去甲肾上腺素是否影响这种关联。这些发现对于确定低社会支持是否会影响血栓形成以及对急性应激的可能急性冠状动脉事件可能具有重要意义。我们研究了男性社会支持与凝血参数对精神应激反应性之间的关系,并确定去甲肾上腺素是否参与其中。

方法

我们测量了63名未服用药物、不吸烟男性(年龄(平均值±平均标准误差)=36.7±1.7岁)的感知社会支持,这些男性在观众面前接受了一项结合公开演讲和心算的急性标准化心理社会应激任务。我们在静息状态、应激后即刻以及应激后20分钟测量了血浆D-二聚体、纤维蛋白原、凝血因子VII活性(FVII:C)和血浆去甲肾上腺素。

结果

独立于体重指数、平均动脉压和年龄,较低的社会支持与基线时较高的D-二聚体和纤维蛋白原水平相关(p<.012),并且与纤维蛋白原(β=-0.36,p=.001;ΔR(2)=.12)和D-二聚体(β=-0.21,p=.017;ΔR(2)=.04)从基线到应激后20分钟的更大升高相关,但与FVII:C无关(p=.83)。一般线性模型显示社会支持和应激对纤维蛋白原、D-二聚体和去甲肾上腺素具有显著的主效应(p<.035)。控制去甲肾上腺素并没有改变所报告的社会支持与凝血指标D-二聚体和纤维蛋白原之间关联的显著性。

结论

我们的结果表明,较低的社会支持与急性应激前后更大的凝血活性相关,这与去甲肾上腺素反应性无关。

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