Duda Krzysztof, Majerczak Joanna, Zoładz Jerzy A, Duda Janina P, Kołodziejski Leszek, Rychlik Urszula, Kulpa Jan
Zakład Fizjologii Mieśni, Akademii Wychowania Fizycznego w Krakowie.
Przegl Lek. 2005;62(7):661-6.
The aim of this study was to evaluate the effect of incremental cycling exercise test performed before and 24 hours after blood donation (withdrawal of 450 ml of blood) on the plasma volume and concentration of morphologic elements of blood. Thirteen subjects (mean +/- SD), age 23 +/- 3 years; body mass 75 +/- 10 kg; BMI 23.4 +/- 2 kg x m(-2); VO2max 2903 +/- 334 ml x min(-1), volunteered for this study. The exercise test started at the power output of 20 W with an increase by 20 W every 3 minutes--until exhaustion. This test was performed once in the control study (7-12 days before blood donation) and repeated 24 hrs after blood donation. The blood samples were taken from the antecubital vein, in a sitting position (1) at rest, (2) at the stage of 100 W power output, (3) at the end of the test (the stage of exhaustion) and (4) at 2 hours after the end of the test. The changes in plasma volume were evaluated according to changes in hemoglobin and hematocrit concentrations. The significance of differences in the studied variables were tested using Wilcoxon test. At the end of the exercise test a significant (p<0.05) decrease in plasma volume was found in both study. It amounted to--11.1 +/- 2.9% in the control study, and to--13.0 +/- 3.9% after blood donation. Within 2 hours after the end of the exercise test plasma volume returned to the pre-exercise value in the control study and exceeded the pre-exercise value by 3.9 +/- 6.7% (p<0.05) in the study performed after blood donation. The MCV, MCH, and MCHC values were not affected by the exercise performed before and after blood donation. In the control study, at the end of the incremental exercise test a significant increase in the leukocyte, lymphocyte and thrombocyte count was found. At 2 hours after exercise thrombocytes count returned to the pre-exercise level, whereas the exercise-induced leucocytosis remained at the end-exercise level. The lymphocyte count decreased to lymphopenic level. During the incremental exercise test performed after blood donation the changes in the concentration of the studied morphologic elements of blood were similar as in the control study. The only difference was noticed in the changes of lymphocyte count which returned to the pre-exercise level within 2 hours after exhaustion. Taking into consideration the changes in plasma volume it was found that during the incremental exercise tests (both in the control study and after blood donation) there was a significant (p<0.05) extra vascular escape of erythrocytes and thrombocytes. This was accompanied by a significant accumulation of neutrophils and lymphocytes in circulating blood. At 2 hours after the end of exercise, neutrophils count increases and lymphocytes migrate into peripheral lymphoid tissues, causing lymphopenia.
本研究旨在评估献血（抽取450毫升血液）前和献血后24小时进行的递增式自行车运动试验对血浆容量和血液形态学成分浓度的影响。13名受试者（平均±标准差），年龄23±3岁；体重75±10千克；体重指数23.4±2千克/米²；最大摄氧量2903±334毫升/分钟，自愿参加本研究。运动试验从20瓦的功率输出开始，每3分钟增加20瓦，直至精疲力竭。该试验在对照研究中（献血前7 - 12天）进行一次，并在献血后24小时重复进行。血样从前臂肘静脉采集，坐姿下（1）休息时，（2）功率输出为100瓦阶段，（3）试验结束时（精疲力竭阶段），以及（4）试验结束后2小时。根据血红蛋白和血细胞比容浓度的变化评估血浆容量的变化。使用Wilcoxon检验测试研究变量差异的显著性。在运动试验结束时，两项研究中均发现血浆容量显著（p<0.05）下降。对照研究中下降至 - 11.1±2.9%，献血后下降至 - 13.0±3.9%。在运动试验结束后2小时内，对照研究中血浆容量恢复到运动前值，而在献血后进行的研究中，血浆容量超过运动前值3.9±6.7%（p<0.05）。平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）和平均红细胞血红蛋白浓度（MCHC）值不受献血前后运动的影响。在对照研究中，递增运动试验结束时发现白细胞、淋巴细胞和血小板计数显著增加。运动后2小时血小板计数恢复到运动前水平，而运动诱导的白细胞增多在运动结束时仍维持。淋巴细胞计数降至淋巴细胞减少水平。在献血后进行的递增运动试验期间，所研究的血液形态学成分浓度变化与对照研究相似。唯一的差异在于淋巴细胞计数的变化，在精疲力竭后2小时内恢复到运动前水平。考虑到血浆容量的变化，发现在递增运动试验期间（对照研究和献血后），红细胞和血小板有显著（p<0.05）的血管外逸出。这伴随着循环血液中中性粒细胞和淋巴细胞的显著积聚。运动结束后2小时，中性粒细胞计数增加，淋巴细胞迁移至外周淋巴组织，导致淋巴细胞减少。
