Hilberg Thomas, Prasa D, Stürzebecher J, Gläser Doreen, Schneider Kathrin, Gabriel Holger H W
Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzerstr. 42, D-07749, Jena, Germany.
Thromb Res. 2003 Mar 15;109(5-6):271-7. doi: 10.1016/s0049-3848(03)00283-4.
Maximal exercise may be a trigger for cardiovascular events. The aim of the study was to investigate changes in blood coagulation and fibrinolysis following maximal short-term exercises with different durations up to 90 s.
A total of 15 healthy nonsmokers underwent three isokinetic maximal tests on an SRM cycle ergometry system with durations of 15, 45, and 90 s. Blood samples were taken after a 30-min rest, immediately before and after exercise, 15 min, and 1 h after completion of exercise. For the investigation of blood coagulation, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin III complex (TAT), intrinsic and extrinsic total (TTPin+ex), and endogenous thrombin potential (ETPin+ex) were measured. For testing fibrinolysis, determinations of plasmin-alpha(2)-antiplasmin complex (PAP), tissue-type plasminogen activator (tPA)-antigen, plasminogen activator inhibitor (PAI)-1-antigen and D-dimer were used.
Immediately after the exercise tests, only F1+2 (15- and 90-s test) and TTPin (45 and 90 s) showed a moderate increase (p<0.05), while TAT and ETP was unchanged. In contrast, a clear increase in PAP and tPA-antigen already after 15 s maximal exercise in relation to the exercise duration time could be investigated. These effects were not totally reversed to baseline 15 min after exercise; D-dimer and PAI-1-antigen still remained unchanged after these types of exercise.
Maximal short-term exercise does not lead to a relevant activation of blood coagulation in healthy young subjects, it is only slightly altered within the normal range. In contrast, fibrinolysis is clearly activated, and the increase is directly dependent on exercise duration. Additionally, it could be shown for the first time that fibrinolysis is already activated after 15 s maximal exercise duration.
最大运动量可能是心血管事件的触发因素。本研究的目的是调查在长达90秒的不同持续时间的最大短期运动后血液凝固和纤维蛋白溶解的变化。
总共15名健康非吸烟者在SRM自行车测力计系统上进行了三次等速最大测试,持续时间分别为15秒、45秒和90秒。在休息30分钟后、运动前、运动后立即、运动结束后15分钟和1小时采集血样。为了研究血液凝固,测量了凝血酶原片段1+2(F1+2)、凝血酶-抗凝血酶III复合物(TAT)、内源性和外源性总凝血时间(TTPin+ex)以及内源性凝血酶潜力(ETPin+ex)。为了测试纤维蛋白溶解,使用了纤溶酶-α(2)-抗纤溶酶复合物(PAP)、组织型纤溶酶原激活剂(tPA)-抗原、纤溶酶原激活剂抑制剂(PAI)-1-抗原和D-二聚体的测定方法。
运动测试后立即,只有F1+2(15秒和90秒测试)和TTPin(45秒和90秒)有中度增加(p<0.05),而TAT和ETP没有变化。相比之下,在最大运动15秒后,就可以观察到PAP和tPA-抗原相对于运动持续时间有明显增加。这些影响在运动后15分钟并未完全恢复到基线水平;在这些类型的运动后,D-二聚体和PAI-1-抗原仍然保持不变。
最大短期运动不会导致健康年轻受试者的血液凝固发生相关激活,只是在正常范围内略有改变。相比之下,纤维蛋白溶解明显被激活,且增加直接依赖于运动持续时间。此外,首次表明在最大运动持续15秒后纤维蛋白溶解就已被激活。