Lippi G, Salvagno G L, Solero G P, Guidi G C
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy.
Int J Sports Med. 2006 May;27(5):359-62. doi: 10.1055/s-2005-865749.
Hematological manipulation to optimize aerobic performances is a serious problem in elite and professional sports and the approach to identify blood doping is as yet challenging. In most cases, the current strategy contemplates a first stage of analysis, based on the application of arbitrary threshold for hemoglobin or hematocrit, followed by second-generation blood tests, or the adoption of an individual hematological passport. To establish the influence of preanalytical variables on the athletes' hematological profile, we compared hemoglobin, hematocrit, and reticulocytes count in 27 male professional cyclists after a mean time of 2.30 +/- 0.12 tourniquet holding. Statistically significant differences were observed for hematocrit (+ 2.4 %; p < 0.001) and hemoglobin measurements (+ 1.4 %; p < 0.001), but not for the reticulocytes count (- 1.9 %; p = 0.170). In 4 out of 27 cases (15 %), the variability of the hematocrit measurement exceeded the 4.1 % desirable analytical quality specification for total error. Results of the present investigation further highlight the risk that unfulfillment of rigorous and standardized procedures for collection of blood specimens might increase the number of false positive testing and might lead to inappropriate sanctioning of a minority of clean athletes with hematocrit or hemoglobin values naturally elevated. Owing to the minor biological variability and the lesser susceptibility to variation of the preanalytical phase, the hemoglobin concentration might be a more suitable parameter than hematocrit for inclusion within laboratory testing to identify blood doping.
通过血液学手段来优化有氧运动表现是精英和职业体育中的一个严重问题，而识别血液兴奋剂的方法至今仍具有挑战性。在大多数情况下，当前的策略是首先基于血红蛋白或血细胞比容的任意阈值进行分析，然后进行第二代血液检测，或者采用个人血液学护照。为了确定分析前变量对运动员血液学特征的影响，我们比较了27名男性职业自行车运动员在平均2.30±0.12分钟的止血带绑扎时间后的血红蛋白、血细胞比容和网织红细胞计数。血细胞比容（+2.4%；p<0.001）和血红蛋白测量值（+1.4%；p<0.001）存在统计学显著差异，但网织红细胞计数（-1.9%；p=0.170）没有差异。在27例中有4例（15%），血细胞比容测量的变异性超过了总误差4.1%的理想分析质量规范。本研究结果进一步凸显了这样一种风险，即不严格执行标准化的血液标本采集程序可能会增加假阳性检测的数量，并可能导致对少数血细胞比容或血红蛋白值自然升高的清白运动员进行不当制裁。由于分析前阶段的生物变异性较小且对变化的敏感性较低，血红蛋白浓度可能比血细胞比容更适合作为实验室检测中识别血液兴奋剂的参数。
