Wang J S, Jen C J, Kung H C, Lin L J, Hsiue T R, Chen H I
Department of Physiology, National Cheng-Kung, University Medical College, Tainan, Taiwan, Republic of China.
Circulation. 1994 Dec;90(6):2877-85. doi: 10.1161/01.cir.90.6.2877.
Platelets play an important role in the pathogenesis of cardiovascular diseases. It is also noticed that on one hand, regular exercise can reduce the risk of cardiovascular diseases, and on the other hand, vigorous exercise provokes sudden cardiac death. We therefore hypothesize that various intensities of exercise may affect platelet function differently.
Strenuous and moderate exercise (about 50% to 55% of peak oxygen consumption, VO2peak) on a bicycle ergometer in 10 sedentary and 10 physically active healthy young men was executed on two separate occasions. Blood samples were collected before and immediately after exercise. A newly designed tapered parallel plate chamber was used to assess platelet adhesiveness. Platelet aggregation induced by ADP was evaluated by the percentage of reduction in single platelet count. beta-Thromboglobulin (beta-TG) and platelet factor 4 (PF4) were measured by ELISA. In addition, a similar study on 5 patients with stable angina were also conducted. Our results showed that (1) in the sedentary healthy group, platelet adhesiveness and aggregation were increased by strenuous exercise and depressed by moderate exercise; (2) in the active healthy group, platelet adhesiveness and aggregation were enhanced by severe exercise, whereas only aggregation was decreased by moderate exercise; (3) in the patients with stable angina, platelet adhesiveness and aggregation were enhanced by strenuous exercise and adhesiveness was suppressed by moderate exercise; (4) the degree of hemoconcentration induced by acute exercise tended to be related to the severity of exercise in all subjects; and (5) although severe exercise elevated beta-TG and PF4, there were no significant changes in beta-TG, PF4, and the ratio of beta-TG to PF4 in healthy subjects after exercise.
It is concluded that platelet adhesiveness and aggregability may be sensitized by strenuous exercise in both healthy subjects and patients with stable angina. In contrast, platelet function can be suppressed significantly by moderate exercise in the healthy and tends to be depressed in patients with stable angina. The former may increase the risk of cardiac arrest and the latter may protect us from cardiovascular diseases. In addition, the effects of acute exercise tend to be more pronounced in the sedentary than in the active.
血小板在心血管疾病的发病机制中起重要作用。人们还注意到，一方面，规律运动可降低心血管疾病风险，另一方面，剧烈运动可引发心源性猝死。因此，我们推测不同强度的运动可能对血小板功能产生不同影响。
10名久坐不动的健康年轻男性和10名身体活跃的健康年轻男性在自行车测力计上进行了两次剧烈运动和中等强度运动（约为最大摄氧量峰值VO₂peak的50%至55%）。在运动前和运动后立即采集血样。使用新设计的锥形平行板腔评估血小板黏附性。通过单个血小板计数减少的百分比评估ADP诱导的血小板聚集。采用酶联免疫吸附测定法测量β-血小板球蛋白（β-TG）和血小板因子4（PF4）。此外，还对5例稳定型心绞痛患者进行了类似研究。我们的结果显示：（1）在久坐不动的健康组中，剧烈运动可增加血小板黏附性和聚集性，中等强度运动则使其降低；（2）在身体活跃的健康组中，剧烈运动可增强血小板黏附性和聚集性，而中等强度运动仅使聚集性降低；（3）在稳定型心绞痛患者中，剧烈运动可增强血小板黏附性和聚集性，中等强度运动则抑制黏附性；（4）急性运动引起的血液浓缩程度在所有受试者中往往与运动强度相关；（5）尽管剧烈运动使β-TG和PF4升高，但健康受试者运动后β-TG、PF4及β-TG与PF4的比值无显著变化。
得出结论，在健康受试者和稳定型心绞痛患者中，剧烈运动可能使血小板黏附性和聚集性敏感化。相比之下，中等强度运动可显著抑制健康受试者的血小板功能，在稳定型心绞痛患者中则倾向于使其降低。前者可能增加心脏骤停风险，后者可能使我们免受心血管疾病侵害。此外，急性运动的影响在久坐不动者中往往比在身体活跃者中更明显。
