В статье представлен обзор современных представлений об изменениях в системе гемостаза в ответ на стресс. Вызванные стрессом нейрогормональные реакции как активируют систему свертывания, так и ингибируют систему фибринолиза, что приводит к гиперкоагуляции. Эволюционная интерпретация таких реакций заключается в том, что гиперкоагуляция при стрессе защищает здоровый организм от избыточного кровотечения в случае травмы в ситуациях «сражайся или беги». Острый психологический стресс может вызвать значительную гемоконцентрацию, а также протромботические изменения в крови. Эти влияния могут оказывать потенциально «вредное» воздействие на сердечно-сосудистую систему.
The article presents an overview of current views of changes in the hemostasis system in response to stress. Stress-induced neurohormonal responses activate the clotting system and inhibit the fibrinolysis system, leading to hypercoagulation. An evolutionary interpretation of such responses is that hypercoagulation under stress protects a healthy body from excessive bleeding in case of trauma in fight-or-flight situations. Acute psychological stress can cause significant hemoconcentration and prothrombotic changes in the blood, which can have potentially “harmful” effects on the cardiovascular system.
1. Koudouovoh-Tripp P, Sperner-Unterweger B. Influence of mental stress on platelet bioactivity. World J Psychiatry. 2012;6(2):134-47.
2. Golaszewska A, Misztal T, Marcinczyk N, et al. Adrenaline May Contribute to Prothrombotic Condition via Augmentation of Platelet Procoagulant Response, Enhancement of Fibrin Formation, and Attenuation of Fibrinolysis. Front Physiol. 2021;12:1-15. DOI:10.3389/fphys.2021.657881
3. Hoirisch-Clapauch S. Anxiety-Related Bleeding and Thrombosis. Semin Thromb Hemost. 2018;44(7):656-61. DOI:10.1055/s-0038-1639501
4. Von Känel R. Acute mental stress and hemostasis: When physiology becomes vascular harm. Thromb Res. 2015;135(Suppl. 1):S52-5. DOI:10.1016/S0049-3848(15)50444-1
5. Bentur OS, Sarig G, Brenner B, Jacob G. Effects of Acute Stress on Thrombosis. Semin Thromb Hemost. 2018;44(07):662-8. DOI:10.1055/s-0038-1660853
6. Austin AW, Patterson SM, Von Känel R. Hemoconcentration and hemostasis during acute stress: interacting and independent effects. Ann Behav Med. 2011;42(2):153-73. DOI:10.1007/s12160-011-9274-0
7. Brenner B, Lisman T. Hemostasis and Thrombosis in Extreme Physiological and Pathological Conditions. Semin Thromb Hemost. 2018;44(07):615-6. DOI:10.1055/s-0038-1666826
8. Kicken CH, Miszta A, Kelchtermans H, Laat B. De Hemostasis during Extreme Exertion. Semin Thromb Hemost. 2018;44(07):640-50. DOI:10.1055/s-0038-1639502
9. Poitras VJ, Pyke KE. The impact of acute mental stress on vascular endothelial function: Evidence, mechanisms and importance. Int J Psychophysiol. 2013;88(2):124-35.
10. Austin AW, Wirtz PH, Patterson SM, et al. Stress-induced alterations in coagulation: Assessment of a new hemoconcentration correction technique. Psychosom Med. 2012;74:288-95. DOI:10.1097/PSY.0b013e318245d950
11. Zgraggen L, Fischer JE, Mischler K, et al. Relationship between hemoconcentration and blood coagulation responses to acute mental stress. Thromb Res. 2005;115:175-83. DOI:10.1016/j.throtrames.2004.08.022
12. Israels SJ. CD63 associates with the alphaIIb beta3 integrin-CD9 complex on the surface of activated platelets. Thromb Haemost. 2001;85:134-41.
13. Semple JW, Italiano JE, Freedman J. Platelets and the immune continuum. Nat Rev Immunol. 2011:264-74. DOI:10.1038 / nri2956
14. Strike PC. Exaggerated platelet and hemodynamic reactivity to mental stress in men with coronary artery disease. Psychosom Med. 2004;66:492-500. DOI:10.1097/01.psy.0000130492.03488.e7
15. Preckel D, von Känel R. Regulation of Hemostasis by the Sympathetic Nervous System: Any Contribution to Coronary Artery Disease? Heartdrug. 2004;4:123-30.
16. Koudouovoh-Tripp P, Hüfner K, Egeter J, et al. Stress Enhances Proinflammatory Platelet Activity : the Impact of Acute and Chronic Mental Stress. J Neuroimmune Pharmacol. 2021;63:500-12. DOI:10.1007/s11481-020-09945-4
17. Von Känel R, Mills PJ, Fainman C, Dimsdale JE. Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: A biobehavioral pathway to coronary artery disease? Psychosom Med. 2001;63:531-44.
18. Sandrini L. Impact of Acute and Chronic Stress on Thrombosis in Healthy Individuals and Cardiovascular Disease Patients. Int J Mol Sci. 2020;21:1-26. DOI:10.3390/ijms21217818
19. Arble E, Arnetz BB. Anticoagulants and the Hemostatic System: A Primer for Occupational Stress Researchers. Int J Environ Res Public Health. 2021;18(20):1-9. DOI:10.3390/ijerph182010626
20. Yau JW, Teoh H, Verma S. Endothelial cell control of thrombosis. BMC Cardiovasc Disord. 2015;15:1-11. DOI:10.1186/s12872-015-0124-z
21. Stuijver DJF, Majoor CJ, van Zaane B, et al. Use of oral glucocorticoids and the risk of pulmonary embolism: A population-based case-control study. Chest. 2013;143:1337-42.
22. Шахматов И.И., Киселев В.И. Универсальные механизмы реагирования системы гемо- стаза на действие различных стрессоров. Бюллетень медицинской науки. 2017;1(5):14‑9 [Shakhmatov II, Kiselev VI. Universal'nyie mekhanizmy reagirovaniia sistemy gemostaza na deistviie razlichnykh stressorov. Biulleten' meditsinskoi nauki. 2017;1(5):14-9 (in Russian)].
23. Austin AW, Wissmann T, Von Kanel R. Stress and hemostasis: An update. Semin Thromb Hemost. 2013;39:902-12. DOI:10.1055/s-0033-1357487
24. Johannesdottir SA, Horváth-Puhó E, Dekkers OM, et al. Use of glucocorticoids and risk of venous thromboembolism: A nationwide population-based case-control study. JAMA Intern Med. 2013;173:743-52.
25. Атауллаханов Ф.И., Румянцев А.Г. Новые представления о свертывании крови. Российский журнал детской гематологии и онкологии. 2018;5(3):13-22 [Ataullakhanov FI, Rumyantsev AG. New insights into the blood clotting. Russian Journal of Pediatric Hematology and Oncology. 2018;5(3):13-22 (in Russian)]. DOI:10.17650/2311-1267-2018-5-3-13-22
26. Тихомирова О.В., Зыбина Н.Н., Ломова И.П., и др. Диагностика и профилактика гиперкоагуляционных нарушений у сотрудников МЧС России с болезнями системы кровообращения: учебно-методическое пособие. СПб.: НПО ПБ АС, 2020 [Tikhomirova OV, Zybina NN, Lomova IP, et al. Diagnostika i profilaktika giperkoaguliatsionnykh narushenii u sotrudnikov MCHS Rossii s bolezniami sistemy krovoobrashcheniia: uchebno-metodicheskoie posobiie. Saint Petersburg: NPO PB AS, 2020 (in Russian)].
27. Зыбина Н.Н., Тихомирова О.В., Старцева О.Н., Вавилова Т.В. Интегральная оценка состояния системы плазменного гемостаза у ликвидаторов последствий аварии на Чернобыльской АЭС с болезнями системы кровообращения. Медико-биологические и социально-психологические проблемы безопасности в чрезвычайных ситуациях. 2017;(4):57-65 [Zybina NN, Tikhomirova OV, Startseva ON, Vavilova TV. Integral Assessment of Plasma Hemostasis State in Chernobyl Accident Recovery Workers with Circulatory Diseases. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2017;(4):57-65 (in Russian)]. DOI:10.25016/2541-7487-2017-0-4-57-65
________________________________________________
1. Koudouovoh-Tripp P, Sperner-Unterweger B. Influence of mental stress on platelet bioactivity. World J Psychiatry. 2012;6(2):134-47.
2. Golaszewska A, Misztal T, Marcinczyk N, et al. Adrenaline May Contribute to Prothrombotic Condition via Augmentation of Platelet Procoagulant Response, Enhancement of Fibrin Formation, and Attenuation of Fibrinolysis. Front Physiol. 2021;12:1-15. DOI:10.3389/fphys.2021.657881
3. Hoirisch-Clapauch S. Anxiety-Related Bleeding and Thrombosis. Semin Thromb Hemost. 2018;44(7):656-61. DOI:10.1055/s-0038-1639501
4. Von Känel R. Acute mental stress and hemostasis: When physiology becomes vascular harm. Thromb Res. 2015;135(Suppl. 1):S52-5. DOI:10.1016/S0049-3848(15)50444-1
5. Bentur OS, Sarig G, Brenner B, Jacob G. Effects of Acute Stress on Thrombosis. Semin Thromb Hemost. 2018;44(07):662-8. DOI:10.1055/s-0038-1660853
6. Austin AW, Patterson SM, Von Känel R. Hemoconcentration and hemostasis during acute stress: interacting and independent effects. Ann Behav Med. 2011;42(2):153-73. DOI:10.1007/s12160-011-9274-0
7. Brenner B, Lisman T. Hemostasis and Thrombosis in Extreme Physiological and Pathological Conditions. Semin Thromb Hemost. 2018;44(07):615-6. DOI:10.1055/s-0038-1666826
8. Kicken CH, Miszta A, Kelchtermans H, Laat B. De Hemostasis during Extreme Exertion. Semin Thromb Hemost. 2018;44(07):640-50. DOI:10.1055/s-0038-1639502
9. Poitras VJ, Pyke KE. The impact of acute mental stress on vascular endothelial function: Evidence, mechanisms and importance. Int J Psychophysiol. 2013;88(2):124-35.
10. Austin AW, Wirtz PH, Patterson SM, et al. Stress-induced alterations in coagulation: Assessment of a new hemoconcentration correction technique. Psychosom Med. 2012;74:288-95. DOI:10.1097/PSY.0b013e318245d950
11. Zgraggen L, Fischer JE, Mischler K, et al. Relationship between hemoconcentration and blood coagulation responses to acute mental stress. Thromb Res. 2005;115:175-83. DOI:10.1016/j.throtrames.2004.08.022
12. Israels SJ. CD63 associates with the alphaIIb beta3 integrin-CD9 complex on the surface of activated platelets. Thromb Haemost. 2001;85:134-41.
13. Semple JW, Italiano JE, Freedman J. Platelets and the immune continuum. Nat Rev Immunol. 2011:264-74. DOI:10.1038 / nri2956
14. Strike PC. Exaggerated platelet and hemodynamic reactivity to mental stress in men with coronary artery disease. Psychosom Med. 2004;66:492-500. DOI:10.1097/01.psy.0000130492.03488.e7
15. Preckel D, von Känel R. Regulation of Hemostasis by the Sympathetic Nervous System: Any Contribution to Coronary Artery Disease? Heartdrug. 2004;4:123-30.
16. Koudouovoh-Tripp P, Hüfner K, Egeter J, et al. Stress Enhances Proinflammatory Platelet Activity : the Impact of Acute and Chronic Mental Stress. J Neuroimmune Pharmacol. 2021;63:500-12. DOI:10.1007/s11481-020-09945-4
17. Von Känel R, Mills PJ, Fainman C, Dimsdale JE. Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: A biobehavioral pathway to coronary artery disease? Psychosom Med. 2001;63:531-44.
18. Sandrini L. Impact of Acute and Chronic Stress on Thrombosis in Healthy Individuals and Cardiovascular Disease Patients. Int J Mol Sci. 2020;21:1-26. DOI:10.3390/ijms21217818
19. Arble E, Arnetz BB. Anticoagulants and the Hemostatic System: A Primer for Occupational Stress Researchers. Int J Environ Res Public Health. 2021;18(20):1-9. DOI:10.3390/ijerph182010626
20. Yau JW, Teoh H, Verma S. Endothelial cell control of thrombosis. BMC Cardiovasc Disord. 2015;15:1-11. DOI:10.1186/s12872-015-0124-z
21. Stuijver DJF, Majoor CJ, van Zaane B, et al. Use of oral glucocorticoids and the risk of pulmonary embolism: A population-based case-control study. Chest. 2013;143:1337-42.
22. Shakhmatov II, Kiselev VI. Universal'nyie mekhanizmy reagirovaniia sistemy gemostaza na deistviie razlichnykh stressorov. Biulleten' meditsinskoi nauki. 2017;1(5):14-9 (in Russian).
23. Austin AW, Wissmann T, Von Kanel R. Stress and hemostasis: An update. Semin Thromb Hemost. 2013;39:902-12. DOI:10.1055/s-0033-1357487
24. Johannesdottir SA, Horváth-Puhó E, Dekkers OM, et al. Use of glucocorticoids and risk of venous thromboembolism: A nationwide population-based case-control study. JAMA Intern Med. 2013;173:743-52.
25. Ataullakhanov FI, Rumyantsev AG. New insights into the blood clotting. Russian Journal of Pediatric Hematology and Oncology. 2018;5(3):13-22 (in Russian).
DOI:10.17650/2311-1267-2018-5-3-13-22
26. Tikhomirova OV, Zybina NN, Lomova IP, et al. Diagnostika i profilaktika giperkoaguliatsionnykh narushenii u sotrudnikov MCHS Rossii s bolezniami sistemy krovoobrashcheniia: uchebno-metodicheskoie posobiie. Saint Petersburg: NPO PB AS, 2020 (in Russian).
27. Zybina NN, Tikhomirova OV, Startseva ON, Vavilova TV. Integral Assessment of Plasma Hemostasis State in Chernobyl Accident Recovery Workers with Circulatory Diseases. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2017;(4):57-65 (in Russian). DOI:10.25016/2541-7487-2017-0-4-57-65