Melanson Stacy E F, Green Sandy M, Wood Malissa J, Neilan Tomas G, Lewandrowski Elizabeth Lee
Division of Clinical Laboratories, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.
Am J Clin Pathol. 2006 Dec;126(6):888-93. doi: 10.1309/1D62H6KRFTVQRJ0A.
Cardiac-related death has been reported following strenuous exercise, and biochemical markers predicting adverse outcomes would be useful. Despite the fact the myeloperoxidase (MPO) release may precede myocardial injury and identify at-risk patients earlier than traditional markers, information on the effects of marathon running on MPO levels is lacking. We measured MPO in conjunction with the creatine kinase MB fraction (CK-MB), myoglobin, troponin T (TnT), and N-terminal B-type natriuretic peptide (NT-proBNP) in 24 athletes before and after a marathon race. Of the 24 athletes, 22 (92%) had an increased MPO level, and the mean MPO level increased from 281.44 pmol/L to 785.21 pmol/L (P < .0001). Results for 14 (58%) of the athletes reached or exceeded the manufacturer's recommended clinical threshold. The increases in CK-MB, myoglobin, TnT, and NT-proBNP also reached statistical significance. Although the elevation in MPO most likely represents a systemic inflammatory response, the concurrent elevations in TnT and NT-proBNP suggest that myocardial injury cannot be excluded.
剧烈运动后曾有心脏相关死亡的报道，因此能够预测不良后果的生化标志物会很有用。尽管髓过氧化物酶（MPO）的释放可能先于心肌损伤，且比传统标志物能更早识别高危患者，但关于马拉松跑步对MPO水平影响的信息却很匮乏。我们在24名运动员参加马拉松比赛前后，对其MPO以及肌酸激酶同工酶MB（CK-MB）、肌红蛋白、肌钙蛋白T（TnT）和N末端B型利钠肽（NT-proBNP）进行了测量。在这24名运动员中，22名（92%）的MPO水平升高，MPO平均水平从281.44 pmol/L升至785.21 pmol/L（P <.0001）。14名（58%）运动员的检测结果达到或超过了制造商推荐的临床阈值。CK-MB、肌红蛋白、TnT和NT-proBNP的升高也具有统计学意义。虽然MPO升高很可能代表全身炎症反应，但TnT和NT-proBNP同时升高表明不能排除心肌损伤。
