Evaluation Of Hypercoagulability In Patients With Major

由于重度抑郁症与血栓栓塞症发病率的增加有关，我们正在测量抑郁症患者和对照受试者的凝血和纤溶实验室参数。有两个研究组：(1)接受长期观察的个人在早晚接受测试，以评估凝血因子VIII和纤溶酶原激活物抑制物-1(PAI-1)的自然日变化可能受到的扰动；(2)接受胰岛素和葡萄糖治疗的个体在输注前后进行测试，以检测凝血因子VIII、凝血酶-抗凝血酶复合体和纤溶酶原激活物抑制物-1的水平。结果：在抑郁症患者中，第八因子的日变化似乎变得迟钝，而第八因子全天保持较高水平。大约四分之一的抑郁症患者在早上和晚上都显著升高了PAI-1。胰岛素输注会增加第八因子和PAI-1，但抑郁症患者的升高幅度比对照组更大。结论：抑郁症患者血栓栓塞症发病率的增加可能与潜在的高凝状态有关。

Because major depression is associated with an increased incidence of thrombembolic disease, we are measuring laboratory parameters of coagulation and fibrinolysis in cohorts of depressed patients and control subjects. There are two study groups: (1) individuals under long-term observation are being tested in the morning and evening to assess possible perturbations in the natural diurnal variation of factor VIII and plasminogen activator inhibitor-1 (PAI-1); (2) individuals being infused with insulin and glucose to assess their insulin resistance are being tested before and after the infusions with measurements of factor VIII, thrombin-antithrombin complexes, and PAI-1. Results: the diurnal variation of factor VIII appears to be blunted in depressed patients, with factor VIII remaining higher throughout the day. Approximately a quarter of the depressed individuals have significantly elevated PAI-1 both in the morning and evening. Insulin infusion increases factor VIII and PAI-1, but the elevations are greater in depressed patients than in control subjects. Conclusions: the increased incidence of thromboembolic disease in patients with major depression may be mediated by underlying hypercoagulability.