摘要
近年的研究表明,运动员中出现运动性贫血者已大为减少,而训练引起的血红蛋白(Hb)值明显降低、但未达到贫血标准的现象却多见,这种现象使红细胞运输O2和CO2的能力及物质能量代谢能力下降,从而影响运动能力。对“运动性低血红蛋白”这一问题,目前尚未见对其造血机制影响和预测指标的研究。因此,通过动物实验和人体试验,本研究旨在探索运动性低血红蛋白造血机制及其早期的诊断方法。动物实验对8周递增负荷游泳训练的大鼠,低血红蛋白出现时造血因子、铁代谢及红细胞生成的变化进行系统研究。人体试验对进行正常训练的游泳运动员血细胞参数的变化,进行为期一年多的纵向研究。主要结果为:
1.研制了新型大鼠运动流动水槽。建立了递增负荷流动水游泳训练8周的大鼠运动性低血红蛋白运动模型。
2.当运动组大鼠Hb降低时,网织红细胞的数量大幅度增加,其中不成熟网织红细胞%增加,成熟网织红细胞比例下降;网织红细胞体积增大;网织红细胞血红蛋白含量增加,网织红细胞血红蛋白含量分布宽度增大。在运动引起的Hb降低过程中,网织红细胞计数参数及其亚型参数的变化均较Hb和RBC提前一周出现。
3. 8周实验中的铁代谢参数显示,未出现大鼠运动性铁缺乏现象。
4.在本研究的动物模型中,当Hb显著降低时,大鼠血清的EPO水平、IL-3和T未发生显著性变化。同时相关性研究发现,运动组大鼠Hb降低、网织红参数出现显著性增加时,IL-6大幅度上升,IL-6与网织红多项参数间存在较密切的正性线性关系。提示我们注意在运动引起的红细胞生成变化的造血调节过程中,IL-6等其它细胞因子的重要作用。
5.人体试验表明:在运动训练引起的Hb降低的早期,网织红参数中的不成熟网织红细胞比例增大,成熟网织红细胞比例降低,红细胞参数中平均红细胞体积增大,平均红细胞血红蛋白含量也降低,但未发现铁缺乏导致Hb降低的现象。
6.动物实验和人体试验的结果共同提示,不成熟网织红细胞比例增加、成熟网织红细胞比例降低和平均红细胞体积增大,这些指标可以用来预测训练中早期运
It was reported that in recent years the number of athletes suffered with sports anemia has been less than it was before. Nevertheless, the reduction of hemoglobin concentration, caused by training, but not reaching the criteria of sports anemia has been often seen. This phenomenon induces the decrease of erythrocyte in O2 and CO2 transport as well as energy metabolism, the result of which is the decrease of exercise capacity. As for the new problem of exercise-induced lower hemoglobin, it was failed to find any report of its effects on haematogenous mechanism and methods for forecasting it. Therefore, the purpose of this study is to explore the haematogenous mechanism of exercise-induced lower hemoglobin and the diagnosis of its early changes by means of animal and human experiments. In animal experiments, when exercise-induced lower hemoglobin occurred in the rats having their incremental loading swimming training for 8 weeks its effects on hematopoietic factors, iron metabolism and erythropoiesis were studied systematically. In human experiments, the changes of haemocyte parameters were studied longitudinally for more than one year in elite swimmers having their normal training. The main results are as follows:
1. A new type of swimming apparatus with flowing water for rats has been developed. A model of rats with exercise-induced lower hemoglobin, having their incremental loading swimming training in flowing water for 8 weeks has been established.
2. In the exercise group, when the rats’hemoglobin concentration decreased, the amount of their reticulocytes increased significantly. Among them, the percentage of the immature reticulocytes increased, but the fraction of the mature reticulocytes decreased. The volume of the reticulocytes increased, but the distribution width of the mean cell hemoglobin concentration decreased. The hemoglobin contents of the reticulocytes increased, and the reticulocyte cell hemoglobin distribution width also increased. In the course of the decrease of hemoglobin, induced by exercise, the reticulocyte count and their subtype parameters changed one week earlier than hemoglobin and erythrocytes did.
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