MORNING INCREASE IN PLATELET AGGREGABILITY - ASSOCIATION WITH ASSUMPTION OF THE UPRIGHT POSTURE
MORNING INCREASE IN PLATELET AGGREGABILITY - ASSOCIATION WITH ASSUMPTION OF THE UPRIGHT POSTURE
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DOI：
10.1161/01.cir.78.1.35
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发表时间：
1988-07-01
期刊：
影响因子：
37.8
通讯作者：
WILLIAMS, GH
中科院分区：
文献类型：
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作者：
BREZINSKI, DA;TOFLER, GH;WILLIAMS, GH
早上 6 点至中午 12 点期间，心肌梗塞和心源性猝死的发病频率增加。血小板聚集性可能在这些疾病的病因中发挥作用，据观察，在正常的早晨醒来、起床和行走活动后，血小板聚集性会增加。为了确定哪些早晨活动或哪些活动导致这种聚集性增加，我们在延迟起床的对照日（即受试者保持仰卧直到中午 12:30）和正常早晨活动分为三个独立组成部分的一天测量了 16 名正常受试者的血小板聚集，即觉醒（上午 8 点）、采取直立姿势（上午 9:30）和走动（上午 11 点）。用于评估血小板聚集性的血样在活动前上午 8 点和每次活动开始后 90 分钟（即上午 9:30、上午 11 点和下午 12:30）抽取。对于该组来说，体外血小板对二磷酸腺苷和肾上腺素的反应性只有在采取直立姿势后才会增加。产生双相血小板聚集所需的激动剂最低浓度在上午 9:30 至 11 点之间（采取直立姿势后 90 分钟）从 3.3.+- 降低（聚集性增加）。 0.3 至 2.4.+-。二磷酸腺苷为 0.2 μM (p < 0.05)，从 2.1 .+- 开始。 0.4 至 1.0.+-.肾上腺素为 0.4 μM (p < 0.05)。在同一时间间隔内，血浆肾上腺素从 34.+- 增加。 7 至 55 .+-. 9 pg/ml (p < 0.05)，血浆去甲肾上腺素从 169 .+- 增加。 19 至 298 .+-。 25 皮克/毫升（p < 0.01）。对照日的聚集性或儿茶酚胺浓度没有显着变化。因此，简单地假设直立姿势就能够导致早晨血小板聚集性增加。认识到直立姿势对血小板聚集性的影响将有助于识别早晨血小板聚集性增加的生化原因，并可能有助于设计消除血小板聚集性潜在有害激增的措施。
The frequencies of onset of myocardial infarction and sudden cardiac death are increased between 6 AM and 12 noon. Platelet aggregability, which may play a role in the cause of these disorders, has been observed to increase after the normal morning activities of awakening, arising, and ambulating. To determine which morning activity or activities are responsible for this aggregability increase, we measured platelet aggregation in 16 normal subjects on a control day of delayed arising (i.e., subjects remained supine until 12:30 PM) and on a day in which normal morning activities were divided into three isolated components of awakening (8 AM), assumption of upright posture (9:30 AM), and ambulating (11 AM). Blood samples to assess platelet aggregability were drawn at 8 AM before activity and 90 minutes after the initiation of each activity (i.e., at 9:30 AM, 11 AM, and 12:30 PM). For the group, in vitro platelet responsiveness to adenosine diphosphate and epinephrine increased only after assumption of the upright posture. The lowest concentration of agonist required to produce biphasic platelet aggregation decreased (aggregability increased) between 9:30 and 11 AM (90 minutes after assumption of the upright posture) from 3.3 .+-. 0.3 to 2.4 .+-. 0.2 .mu.M for adenosine diphosphate (p < 0.05) and from 2.1 .+-. 0.4 to 1.0 .+-. 0.4 .mu.M for epinephrine (p < 0.05). During the same interval, plasma epinephrine increased from 34 .+-. 7 to 55 .+-. 9 pg/ml (p < 0.05), and plasma norepinephrine increased from 169 .+-. 19 to 298 .+-. 25 pg/ml (p < 0.01). There was no significant change in aggregability or catecholamine concentrations on the control day. Thus, the simple assumption of upright posture is capable of causing the morning increase of platelet aggregability. Recognition of the effect of the assumption of upright posture on platelet aggregability will assist in identification of the biochemical cause of the platelet aggregability increase in the morning and may facilitate design of measures to eliminate potentially harmful surges in platelet aggregability.