Evaluation Of Hypercoagulability In Patients With Major

重症患者高凝状态的评估

• 批准号: 6825561
• 负责人: mcdonald k horne
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6825561
• 关键词: antithrombins; blood coagulation disorders; circadian rhythms; coagulation factor VIII; comorbidity; diagnostic tests; glucose; human subject; injection /infusion; insulin sensitivity /resistance; major depression; patient oriented research; plasminogen activator inhibitors; thrombin; thromboembolism

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.

由于重度抑郁症与血栓性疾病的发病率增加有关，我们正在测量抑郁症患者和对照受试者的凝血和纤溶的实验室参数。有两个研究组：(1)长期观察的个体在早上和晚上进行测试，以评估因子VIII和纤溶酶原激活物抑制剂-1 （PAI-1）的自然日变化可能受到的扰动；(2)注射胰岛素和葡萄糖以评估胰岛素抵抗的个体在注射前后进行因子VIII、凝血酶-抗凝血酶复合物和PAI-1的检测。结果：在抑郁症患者中，因子VIII的日变化趋于平缓，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有明显升高的PAI-1。胰岛素输注增加因子VIII和PAI-1，但抑郁症患者的升高幅度大于对照组。结论：重度抑郁症患者血栓栓塞性疾病发生率的增加可能是由潜在的高凝性介导的。