Israel, Haifa.
Med Hypotheses. 2017 Sep;106:61-70. doi: 10.1016/j.mehy.2017.07.001. Epub 2017 Jul 3.
In this article is given the new insight about the affection of stress on the increase of level of low density lipoproteins (LDL) in the blood, which is connected with the disturbance of hydrodynamics in the bloodstream, the attention was paid to the cylindrical cholesterol plaque, and it's classification. The disturbance of hydrodynamics of blood under the stress leads to the formation of a cylindrical cholesterol plaque, which repeats the contour of the vessel, and leads to the ischemic disorders of the heart and brain. The cylindrical cholesterol plaque goes through several stages of development: friable, yielding, dense, old. In the case of destruction of friable, fresh cholesterol plaque, releases a big quantity of low-density lipoproteins. This leads to the pathological increase of level of LDL in the blood. In the case of long disturbance of hydrodynamics, occurs the formation of strong links between low-density lipoproteins. Yielding cholesterol plaque is formed. Further maturation of cylindrical cholesterol plaque, leads to it's densifying and damage. We may emphasize, that short periods of strong contraction and expansion of vessels lead to the increase of level of LDL in the blood. Self-dependent restoration of normal level of LDL in blood occurs in the case of restoration of pressure in the limits of numbers, which are specific for particular person, and which don't exceed the physiological standard. Among patients with long duration of stress, the duration of vasospasm increases. LDL, without having a possibility to crumble, begin to stick together and form the yielding cylindrical plaque. It is characterized by having of not so strong connection with the vascular wall, and maintains only at the expanse of iteration of the vascular wall, it has cylindrical shape, is elastic and yellow. The thickness and length of walls depends on the degree of cross-clamping during the time of formation of yielding cylindrical plaque. In the case of stopping of spasm, yielding cylindrical plaque can resolve slowly. Among hypotensive and individuals, which have normal pressure, the increase of level of LDL isn't noted. There aren't such investigations, where such link was noted. The increasing of level of LDL among these people (especially under the stress) can say about cases of short-term increase of pressure, which could be unnoticed. These patients require pressure monitoring and, accordingly, the adjustment of the state of stress and anger.
本文介绍了压力对血液中低密度脂蛋白(LDL)水平升高的影响的新见解,这种升高与血流动力学紊乱有关。本文特别关注了圆柱形胆固醇斑块及其分类。压力下的血流动力学紊乱导致圆柱形胆固醇斑块的形成,该斑块重复了血管的轮廓,导致心脏和大脑的缺血性障碍。圆柱形胆固醇斑块经历了几个发展阶段:脆弱、易碎、密集、陈旧。在脆弱、新鲜的胆固醇斑块破坏的情况下,会释放大量的低密度脂蛋白。这导致血液中 LDL 水平病理性升高。在长时间血流动力学紊乱的情况下,会在低密度脂蛋白之间形成强连接。易碎的胆固醇斑块形成。进一步成熟的圆柱形胆固醇斑块会导致其致密化和损伤。我们可以强调,血管的强烈收缩和扩张的短时间会导致 LDL 水平升高。在压力恢复到特定个体特有的特定范围内并且不超过生理标准的情况下,血液中 LDL 水平会自行恢复正常。在长期处于压力状态的患者中,血管痉挛持续时间增加。没有碎裂机会的 LDL 开始粘在一起形成易碎的圆柱形斑块。它的特点是与血管壁的连接不那么强,并且仅在血管壁的重复扩张的情况下维持,它具有圆柱形形状、弹性和黄色。壁的厚度和长度取决于形成易碎的圆柱形斑块时的夹闭程度。在痉挛停止的情况下,易碎的圆柱形斑块可以缓慢溶解。在低血压和血压正常的个体中,没有注意到 LDL 水平升高。没有这样的研究记录到这种联系。这些人中 LDL 水平的升高(特别是在压力下)可能表明存在短期压力升高,但未被察觉。这些患者需要进行血压监测,并相应地调整压力和愤怒状态。