Chow Vincent, Reddel Caroline, Pennings Gabrielle, Scott Elizabeth, Pasqualon Tundra, Ng Austin C C, Yeoh Thomas, Curnow Jennifer, Kritharides Leonard
ANZAC Research Institute, Sydney, Australia; Department of Cardiology, Concord Repatriation General Hospital, Sydney Local Health District, Sydney, Australia; University of Sydney, Australia.
Brain & Mind Research Institute, University of Sydney, Australia.
Schizophr Res. 2015 Mar;162(1-3):175-82. doi: 10.1016/j.schres.2014.12.042. Epub 2015 Jan 27.
Patients with schizophrenia are at increased risk of venous thromboembolism. The mechanisms underlying this association are poorly understood.
We investigated whether there is a global hypercoagulable state in patients with schizophrenia utilising the overall haemostatic potential (OHP) assay which assesses overall coagulation potential (OCP), haemostatic potential (OHP) and fibrinolytic potential (OFP).
Citrated plasma was collected for OHP assays from patients with schizophrenia on long-term antipsychotic treatment and compared with healthy age- and sex-matched controls. Time courses of fibrin formation and degradation were measured by spectrophotometry (absorption of 405nm) after the addition of tissue factor and tissue plasminogen activator to plasma.
Ninety patients with schizophrenia (antipsychotic treatment-15.9±9.7years) and 30 controls were recruited. Patients with schizophrenia had higher rates of smoking and levels of inflammatory markers (high-sensitivity C-reactive protein and neutrophil-to-lymphocyte ratio) than controls. Whilst D-dimer, fibrinogen and platelet count did not differ between patients with schizophrenia and controls, the OCP (54.0±12.6 vs 45.9±9.1, p=0.002) and OHP (12.6±5.8 vs 7.2±3.7, p<0.001) were higher, and OFP was lower (76.6±9.8% vs 84.9±6.4%, p<0.001) in patients with schizophrenia, implying both a hypercoagulable and hypofibrinolytic state in these patients. Importantly, abnormalities in overall coagulation were independently predicted by levels of plasminogen-activator-inhibitor-1, fibrinogen, platelet count, inflammatory markers and plasma triglycerides, suggesting a multifactorial aetiology.
Patients with schizophrenia have evidence of a global hypercoagulable and hypofibrinolytic state which may contribute to their increased risk of venous thromboembolism.
精神分裂症患者发生静脉血栓栓塞的风险增加。这种关联背后的机制尚不清楚。
我们利用整体止血潜力（OHP）检测方法，研究精神分裂症患者是否存在全身性高凝状态，该检测方法可评估整体凝血潜力（OCP）、止血潜力（OHP）和纤维蛋白溶解潜力（OFP）。
收集长期接受抗精神病药物治疗的精神分裂症患者的枸橼酸盐血浆进行OHP检测，并与年龄和性别匹配的健康对照者进行比较。在血浆中加入组织因子和组织纤溶酶原激活剂后，通过分光光度法（405nm吸光度）测量纤维蛋白形成和降解的时间进程。
招募了90例精神分裂症患者（抗精神病药物治疗时间为15.9±9.7年）和30名对照者。精神分裂症患者的吸烟率和炎症标志物（高敏C反应蛋白和中性粒细胞与淋巴细胞比值）水平高于对照者。虽然精神分裂症患者与对照者之间的D-二聚体、纤维蛋白原和血小板计数没有差异，但精神分裂症患者的OCP（54.0±12.6 vs 45.9±9.1，p = 0.002）和OHP（12.6±5.8 vs 7.2±3.7，p < 0.001）较高，而OFP较低（76.6±9.8% vs 84.9±6.4%，p < 0.001），这意味着这些患者存在高凝状态和低纤维蛋白溶解状态。重要的是，纤溶酶原激活物抑制剂-1、纤维蛋白原、血小板计数、炎症标志物和血浆甘油三酯水平可独立预测整体凝血异常，提示其病因是多因素的。
精神分裂症患者有全身性高凝和低纤维蛋白溶解状态的证据，这可能导致他们发生静脉血栓栓塞的风险增加。
