Klinik für Anästhesiologie, Klinikum der Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Eur J Med Res. 2010 Feb 26;15(2):59-65. doi: 10.1186/2047-783x-15-2-59.
Serious thrombembolic events occur in otherwise healthy marathon athletes during competition. We tested the hypothesis that during heavy endurance sports coagulation and platelets are activated depending on the type of endurance sport with respect to its running fraction.
68 healthy athletes participating in marathon (MAR, running 42 km, n = 24), triathlon (TRI, swimming 2.5 km + cycling 90 km + running 21 km, n = 22), and long distance cycling (CYC, 151 km, n = 22) were included in the study. Blood samples were taken before and immediately after completion of competition to perform rotational thrombelastometry. We assessed coagulation time (CT), maximum clot firmness (MCF) after intrinsically activation and fibrin polymerization (FIBTEM). Furthermore, platelet aggregation was tested after activation with ADP and thrombin activating peptide 6 (TRAP) by using multiple platelet function analyzer.
Complete data sets were obtained in 58 athletes (MAR: n = 20, TRI: n = 19, CYC: n = 19). CT significantly decreased in all groups (MAR -9.9%, TRI -8.3%, CYC -7.4%) without differences between groups. In parallel, MCF (MAR +7.4%, TRI +6.1%, CYC +8.3%) and fibrin polymerization (MAR +14.7%, TRI +6.1%, CYC +8.3%) were significantly increased in all groups. However, platelets were only activated during MAR and TRI as indicated by increased AUC during TRAP-activation (MAR +15.8%) and increased AUC during ADP-activation in MAR (+50.3%) and TRI (+57.5%).
While coagulation is activated during physical activity irrespective of type we observed significant platelet activation only during marathon and to a lesser extent during triathlon. We speculate that prolonged running may increase platelet activity, possibly, due to mechanical alteration. Thus, particularly prolonged running may increase the risk of thrombembolic incidents in running athletes.
在健康的马拉松运动员比赛中，会发生严重的血栓栓塞事件。我们检验了以下假设：在剧烈的耐力运动中，凝血和血小板会根据耐力运动的类型及其跑步比例而被激活。
本研究纳入了 68 名健康的马拉松运动员（MAR，跑步 42 公里，n = 24）、三项全能运动员（TRI，游泳 2.5 公里+骑自行车 90 公里+跑步 21 公里，n = 22）和长距离自行车运动员（CYC，151 公里，n = 22）。在比赛结束前后采集血液样本进行旋转血栓弹性测定。我们评估了内在激活后凝血时间（CT）、最大血凝块硬度（MCF）和纤维蛋白聚合（FIBTEM）。此外，使用多血小板功能分析仪，通过 ADP 和血栓激活肽 6（TRAP）激活后测试血小板聚集。
58 名运动员（MAR：n = 20，TRI：n = 19，CYC：n = 19）获得完整的数据。所有组的 CT 均显著降低（MAR -9.9%，TRI -8.3%，CYC -7.4%），但组间无差异。同时，所有组的 MCF（MAR +7.4%，TRI +6.1%，CYC +8.3%）和纤维蛋白聚合（MAR +14.7%，TRI +6.1%，CYC +8.3%）均显著增加。然而，只有在 MAR 和 TRI 中血小板被激活，这表明在 TRAP 激活期间 AUC 增加（MAR +15.8%）和在 ADP 激活期间 AUC 增加（MAR +50.3%，TRI +57.5%）。
尽管在运动过程中凝血被激活，但其类型并不重要，但我们观察到只有在马拉松和三项全能运动中才会发生明显的血小板激活。我们推测，长时间的跑步可能会增加血小板的活性，可能是由于机械改变所致。因此，特别是长时间的跑步可能会增加跑步运动员发生血栓栓塞事件的风险。
