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马拉松式骑行对肾功能的影响。

The effect of marathon cycling on renal function.

作者信息

Neumayr G, Pfister R, Hoertnagl H, Mitterbauer G, Getzner W, Ulmer H, Gaenzer H, Joannidis M

机构信息

Institute of Sports Medicine, University Clinics of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.

出版信息

Int J Sports Med. 2003 Feb;24(2):131-7. doi: 10.1055/s-2003-38205.

Abstract

The stress of strenuous long-term exercise may alter renal function. Whether this is also true for marathon cycling is unknown so far. The purpose of this study was to evaluate renal function following competitive marathon cycling. We investigated 38-male, well-trained recreational cyclists credibly not taking any kind of doping who participated in the Otztal Radmarathon. Blood and urine specimens were taken the day before, immediately after and one day after competition. Baseline renal functional parameters--normal before competition--increased significantly afterwards and remained elevated during 24 hours of recovery. The rises in serum creatinine, urea and uric acid were 20, 54 and 42 % (p < 0.001 respectively). The corresponding decline in estimated creatinine clearance was 18 %. In all athletes the serum urea/creatinine ratio rose above 40, fractional sodium excretion and fractional uric acid excretion fell below 0.4 % and 15 %, indicating reduced renal perfusion. The observed effects lasted for at least 24 h despite a stable fluid balance during the race and an expanding plasma volume (PV) in the recovery period. Levels of haematocrit remained unchanged immediately post-race but significantly declined from 0.44 to 0.41 on the following day (p < 0.001). The calculated rise in PV was + 10.8 %. Electrolyte homeostasis was preserved throughout the observation period. Post-exercise proteinuria was small and of the mixed glomerular-tubular type. There was neither evidence for exercise-induced haemolysis, nor for significant skeletal muscle damage. The finding obtained from well-hydrated recreational athletes reveals that the extraordinary strains of marathon cycling influence renal function only on a minimal scale. Though minor, the physiological effects were long-lasting. The results obtained suggest that a reduced renal perfusion is the mechanism responsible for the slight impairment of renal function following exhaustive marathon cycling.

摘要

长期剧烈运动的压力可能会改变肾功能。迄今为止,马拉松骑行是否也是如此尚不清楚。本研究的目的是评估竞技马拉松骑行后的肾功能。我们调查了38名训练有素的男性业余自行车运动员,他们确实没有服用任何兴奋剂,参加了奥茨山谷自行车马拉松赛。在比赛前一天、比赛结束后立即以及比赛后一天采集血液和尿液样本。比赛前正常的基线肾功能参数在比赛后显著升高,并在24小时的恢复过程中一直保持升高。血清肌酐、尿素和尿酸的升高分别为20%、54%和42%(p均<0.001)。估计的肌酐清除率相应下降了18%。在所有运动员中,血清尿素/肌酐比值升至40以上,钠排泄分数和尿酸排泄分数降至0.4%和15%以下,表明肾灌注减少。尽管比赛期间液体平衡稳定且恢复期血浆量增加(PV),但观察到的影响至少持续24小时。赛后血细胞比容水平立即保持不变,但在第二天从0.44显著降至0.41(p<0.001)。计算得出的PV升高为+10.8%。在整个观察期内电解质稳态得以维持。运动后蛋白尿较少,为混合性肾小球-肾小管型。既没有运动诱发溶血的证据,也没有明显骨骼肌损伤的证据。从水分充足的业余运动员身上获得的研究结果表明,马拉松骑行的巨大压力对肾功能的影响仅在最小程度上。尽管影响较小,但生理效应是持久的。所得结果表明,肾灌注减少是马拉松骑行后肾功能轻微受损的原因。

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