Rock G, Tittley P, Pipe A
Department of Medicine, University of Ottawa, Ontario, Canada.
Clin J Sport Med. 1997 Apr;7(2):94-9. doi: 10.1097/00042752-199704000-00004.
To compare preexercise with immediate and 24 h postvalues of coagulation parameters in experienced athletes following a single, 42-km marathon run.
Blood samples were taken 18 h before, immediately after, and 24 h after a marathon race from 14 well-trained individuals, and coagulation factors were measured.
The setting was a 42-km race on a cloudy day in May with an ambient temperature of 22 degrees C.
The subjects were fourteen normal healthy individuals (12 men and 2 women) who regularly participated in runs of at least 20 km each week.
The subjects all undertook a 42-km marathon run followed by a 24-h rest period and a repeat assessment.
Coagulation factors including factor VIII (FVIII) and von Willebrand factor (vWF) were measured, as was the platelet response to aggregating agents. These responses are all considered as primary outcome measures of hypercoagulability and reflect the prethrombotic state.
The hematocrit was not altered immediately after the race, but the platelet count (mean +/- SD) was significantly elevated (p < 0.05) to 322 +/- 54 x 10(9)/L from 256 +/- 70 x 10(9)/L, and the mean platelet size increased by 24 h (p < 0.05). Platelet aggregation in response to epinephrine, adenosine diphosphate, and collagen was decreased by 40%, 15%, and 60%, respectively, at 24 h; the response to ristocetin was only slightly (10%) altered. There was a significant elevation of beta-thromboglobulin in the plasma at the end of the race, and this elevation persisted for 24 h, indicating considerable release from the platelet alpha granules. The effect on platelet function was further demonstrated by a decrease in the quantity of glycoprotein Ib at 24 h, but not immediately after the race. There was an approximately 300% increase in the levels of FVIII, vWF antigen (vWF:Ag), and ristocetin cofactor activity. In addition, the normal vWF:Ag multimer pattern was changed in the samples taken immediately after the race.
The data support the evidence of significant alteration of certain factors that are involved in coagulation following endurance exercise. Increases in FVIII and vWF are also noted in some prethrombotic conditions. The decreased platelet aggregation suggests early activation during the period of exercise.
比较经验丰富的运动员在完成单次42公里马拉松赛后运动前、运动后即刻及运动后24小时凝血参数的值。
从14名训练有素的个体中，在马拉松比赛前18小时、比赛结束后即刻及比赛结束后24小时采集血样，并检测凝血因子。
比赛于5月一个阴天举行，赛程42公里，环境温度为22摄氏度。
受试者为14名正常健康个体（12名男性和2名女性），他们每周定期参加至少20公里的跑步。
受试者均完成一次42公里的马拉松跑，随后休息24小时并进行重复评估。
检测包括凝血因子VIII（FVIII）和血管性血友病因子（vWF）在内的凝血因子，以及血小板对聚集剂的反应。这些反应均被视为高凝状态的主要观察指标，并反映血栓前状态。
赛后即刻血细胞比容未改变，但血小板计数（均值±标准差）从256±70×10⁹/L显著升高（p<0.05）至322±54×10⁹/L，且平均血小板体积在24小时时增大（p<0.05）。在24小时时，血小板对肾上腺素、二磷酸腺苷和胶原的聚集反应分别降低了40%、15%和60%；对瑞斯托霉素的反应仅略有改变（10%）。比赛结束时血浆中β-血小板球蛋白显著升高，且这种升高持续24小时，表明血小板α颗粒大量释放。对血小板功能的影响在24小时时通过糖蛋白Ib数量的减少进一步得到证实，但赛后即刻未出现这种情况。FVIII、vWF抗原（vWF:Ag）和瑞斯托霉素辅因子活性水平升高约300%。此外，赛后即刻采集的样本中正常的vWF:Ag多聚体模式发生了改变。
数据支持耐力运动后参与凝血的某些因子发生显著改变的证据。在一些血栓前状态中也观察到FVIII和vWF升高。血小板聚集减少表明运动期间早期激活。
