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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Diurnal variations in coagulation and fibrinolysis in vital exhaustion.
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Diurnal variations in coagulation and fibrinolysis in vital exhaustion.

机译：生命力衰竭中凝血和纤维蛋白溶解的昼夜变化。

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OBJECTIVE: Vital exhaustion (VE) predicts a first myocardial infarction (MI) and new cardiac events after a coronary angioplasty. To explore potential underlying pathophysiological mechanisms, we tested whether VE is associated with more pronounced diurnal variations in hemostasis. METHODS: Blood was drawn from 29 VE and 30 control males, all healthy and nonsmokers, to assess hemostatic measures at 7:00 AM and 6:00 PM. RESULTS: All measures of fibrinolysis were in their normal range and showed significant diurnal variations. These variations were more pronounced in VE as all fibrinolytic measures were significantly higher in VE at 7:00 AM and similar to those of controls at 6:00 PM, thus supporting our hypothesis with respect to fibrinolysis. Diurnal decreases in tPA and tPA-PAI ranged from 1.5 (VE) to 1.3 (controls), whereas the diurnal decrease in PAI-1 was more than fourfold in VE and 2.7-fold in controls. This suggests a decreased fibrinolytic capacity in VE during the early morning. All coagulation measures were in their normal range, and prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complexes, and activated factor VII showed significant diurnal variations. These variations were similar in VE and control individuals, thus not supporting our hypothesis with respect to coagulation. Finally, F1+2 and fibrinogen were both significantly higher throughout the day in VE. CONCLUSIONS: VE is associated with decreased early morning fibrinolysis and increased fibrinogen levels throughout the day. These hemostatic changes may promote thrombus formation and provide a potential pathophysiological mechanism by which VE is related to MI and its circadian variation.
机译：目的：体力衰竭（VE）可以预测冠状动脉成形术后的首次心肌梗塞（MI）和新的心脏事件。为了探索潜在的潜在病理生理机制，我们测试了VE是否与止血中更明显的昼夜变化相关。方法：从29名VE和30名对照男性（均为健康和非吸烟者）抽取血液，以评估上午7:00和下午6:00的止血措施。结果：所有纤维蛋白溶解指标均在正常范围内，并表现出明显的昼夜变化。这些变化在VE中更为明显，因为VE的所有纤溶措施在7:00 AM显着更高，并且与6:00 PM的对照相似，因此支持了我们关于纤溶的假设。 tPA和tPA-PAI的昼夜减少幅度为1.5（VE）至1.3（对照），而PAI-1的昼夜减少幅度为VE的4倍以上，而对照为2.7倍。这表明在清晨VE中的纤溶能力降低。所有凝血措施均在其正常范围内，凝血酶原片段1 + 2（F1 + 2），凝血酶-抗凝血酶复合物和活化因子VII显示出明显的昼夜变化。这些变异在VE和对照个体中相似，因此不支持我们关于凝血的假设。最后，VE中全天F1 + 2和纤维蛋白原均显着升高。结论：VE与全天早晨纤溶减少和纤维蛋白原水平升高有关。这些止血变化可能促进血栓形成，并提供潜在的病理生理机制，VE与MI以及其昼夜变化有关。

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