van den Burg P J, Hospers J E, van Vliet M, Mosterd W L, Huisveld I A
Department of Medical Physiology and Sports Medicine, University of Utrecht, The Netherlands.
Eur Heart J. 1995 Dec;16(12):1995-2001. doi: 10.1093/oxfordjournals.eurheartj.a060859.
During acute exercise both coagulant and fibrinolytic potential increase. Since strenuous exertion is associated with an enhanced risk for cardiac events, especially in untrained individuals, it is important to determine whether the initial haemostatic balance is maintained during exercise. Twenty-nine sedentary males (20-30 years) were subjected to a standardized cycle ergometer test. Blood samples were obtained at two exercise levels, 70% VO2max (submaximal), 100% VO2max (maximal) and during 25 min recovery. Both during submaximal and maximal performance, tissue type plasminogen activator antigen, urokinase plasminogen activator antigen and tissue type plasminogen activator activity were increased. A concomitant enhancement of clotting activity of factors VII, VIII, IX, XII and fibrinogen resulted in a shortening of clotting times. Following correction for changes in plasma volume, the results for factor VII:c were reversed, and factor XII:c and fibrinogen no longer demonstrated exercise-related changes. Increases in coagulant (activated partial thromboplastin time) and fibrinolytic (tissue type plasminogen activator activity) potential proceeded in parallel during exercise. However, during recovery while there was a sustained increase in coagulant potential, fibrinolytic potential demonstrated a sharp fall. We conclude that during physical activity, while parallel changes in coagulant and fibrinolytic activity occur, this haemostatic balance is not maintained during recovery. This phenomenon could constitute an enhanced risk for coronary artery thrombosis which may contribute to exercise-related cardiovascular events.
在急性运动期间，凝血和纤溶潜能均会增加。由于剧烈运动与心脏事件风险增加相关，尤其是在未经训练的个体中，因此确定运动期间初始止血平衡是否得以维持非常重要。29名久坐不动的男性（20 - 30岁）接受了标准化的自行车测力计测试。在两个运动水平，即70%最大摄氧量（次最大）、100%最大摄氧量（最大）以及恢复的25分钟期间采集血样。在次最大和最大运动表现期间，组织型纤溶酶原激活物抗原、尿激酶型纤溶酶原激活物抗原和组织型纤溶酶原激活物活性均增加。凝血因子VII、VIII、IX、XII和纤维蛋白原的凝血活性随之增强，导致凝血时间缩短。在对血浆量变化进行校正后，因子VII:c的结果发生逆转，因子XII:c和纤维蛋白原不再显示出与运动相关的变化。运动期间，凝血潜能（活化部分凝血活酶时间）和纤溶潜能（组织型纤溶酶原激活物活性）的增加并行发生。然而，在恢复期间，虽然凝血潜能持续增加，但纤溶潜能急剧下降。我们得出结论，在体力活动期间，虽然凝血和纤溶活性会并行变化，但在恢复期间这种止血平衡并未维持。这种现象可能构成冠状动脉血栓形成风险增加，这可能导致与运动相关的心血管事件。
