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【medical-news】汇023 心血管病与自然灾难：地震引
9: Hypertens Res. 2003 May;26(5):355-67.
Disasters and the heart: a review of the effects of earthquake-induced stress on
cardiovascular disease.
灾难和心脏：一项地震影响的调查-引发心血管疾病
Kario K, McEwen BS, Pickering TG.
Department of Cardiology, Jichi Medical School, Tochigi, Japan.
kkario@jichi.ac.jp
There is growing evidence that stress contributes to cardiovascular disease. Chronic stress contributes to the atherosclerotic process through increased allostatic load, which is mediated by the neuroendocrine and immune systems (sympathetic nervous system and hypothalamus-pituitary adrenal axis) and related chronic risk factors (insulin resistance syndrome, hypertension, diabetes, and hyperlipidemia). In addition, acute stress can trigger cardiovascular events predominantly through sympathetic nervous activation and potentiation of acute risk factors (blood pressure increase, endothelial cell dysfunction, increased blood viscosity, and platelet and hemostatic activation). Earthquakes provide a good example of naturally occurring acute and chronic stress, and in this review we focus mainly on the effects of the Hanshin-Awaji earthquake on the
cardiovascular system. The Hanshin-Awaji earthquake resulted in a 3-fold increase
of myocardial infarctions in people living close to the epicenter, particularly in women, with most of the increase occurring in nighttime-onset events. There was also a near doubling in the frequency of strokes. These effects may be mediated by changes in hemostatic factors, as demonstrated by an increase of D-dimer, von Willebrand factor, and tissue-type plasminogen activator (tPA) antigen. Blood pressure also increased after the earthquake, and was prolonged for several weeks in patients with microalbuminuria.
越来越多的证据显示应激反应会导致心血管疾病。慢性应激反应通过增加适应负荷导致动脉粥样硬化，这个过程受神经内分泌、免疫系统（交感神经系统和下丘脑-垂体-肾上腺轴）及相关慢性风险因素（胰岛素耐受综合征、高血压、糖尿病和高血脂）的调节。另外，急性应激会引发心血管疾病发作，其主要通过兴奋交感神经及潜在的急性风险因素（血压升高、内皮细胞功能障碍、血液黏度增加及激活血小板和其他止血因子）导致发病。地震提供了一种自然条件下的急性和慢性应激反应，在这则综述中，我们主要集中讨论Hanshin-Awaji地震对心血管疾病的影响。Hanshin-Awaji地震导致震中附近居民心肌梗塞增加3倍（尤其是女性），且发病大部分位于夜间。中风的发生率也几乎增加一倍。这些作用可能由止血因子变化所致，例如D-二聚物、von Willebrand因子及组织型血浆酶原激活因子（rPA）抗原增加。地震后血压也会升高，而且对于微量白蛋白尿患者血压升高会持续数周。
Publication Types:
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review
PMID: 12887126 [PubMed - indexed for MEDLINE]
http://www.dxy.cn/bbs/post/view?bid=116&id=11840276&sty=3&age=0&tpg=1&ppg=1#11840276 初步校译:
越来越多的证据显示应激反应会导致心血管疾病。慢性应激反应通过增加适应负荷导致动脉粥样硬化，这个过程受神经内分泌、免疫系统（交感神经系统和下丘脑-垂体-肾上腺轴）及相关慢性风险因素（胰岛素耐受综合征、高血压、糖尿病和高血脂）的调节。另外，急性应激会引发心血管疾病发作，其主要通过兴奋交感神经及潜在的急性风险因素（血压升高、内皮细胞功能障碍、血液黏度增加及激活血小板和其他止血因子）导致发病。地震提供了一种自然条件下的急性和慢性应激反应，在这则综述中，我们主要集中讨论Hanshin-Awaji地震对心血管疾病的影响。Hanshin-Awaji地震导致震中附近居民心肌梗塞增加3倍（尤其是女性），且发病大部分位于夜间。中风的发生率也几乎增加一倍。这些作用可能由止血因子变化所致，例如D-二聚物、von Willebrand因子及组织型血浆酶原激活因子（rPA）抗原增加。地震后血压也会升高，而且对于微量白蛋白尿患者血压升高会持续数周。
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作者:admin@医学,生命科学 2010-11-04 05:11
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