Brun J F, Khaled S, Raynaud E, Bouix D, Micallef J P, Orsetti A
Service d'Exploration Physiologique des Hormones et des Métabolismes, CHRU de Montpellier, France.
Clin Hemorheol Microcirc. 1998 Oct;19(2):89-104.
The life-extending effects of regular exercise are related to a decrease in both coronary and peripheral vascular morbidity, associated with some improvements in cardiovascular risk factors. A possible link between the beneficial metabolic and hemodynamic effects of exercise could be blood rheology, which is markedly affected by exercise. We propose here a description of the hemorheological effects of exercise as a triphasic phenomenon. Short-term effects of exercise are an increase in blood viscosity resulting from both fluid shifts and alterations of erythrocyte rheologic properties (rigidity and aggregability). Increased blood lactate, stress, and acute phase play a role in this process. Middle-term effects of regular exercise are a reversal of these acute effects with an increase in blood fluidity, explained by plasma volume expansion (autohemodilution) that lowers both plasma viscosity and hematocrit. Long-term effects further improve blood fluidity, parallel with the classical training-induced hormonal and metabolic alterations. While body composition, blood lipid pattern, and fibrinogen improve (thus decreasing plasma viscosity), erythrocyte metabolic and rheologic properties are modified, with a reduction in aggregability and rigidity. On the whole, these improvements reflect a reversal of the so-called "insulin-resistance syndrome" induced by a sedentary lifestyle. Since impaired blood rheology has been demonstrated to be at risk for vascular diseases, the hemorheologic effects of exercise can be hypothesized to be a mechanism (or at least a marker) of risk reversal. This latter point requires further investigation. The physiological meaning of the triphasic pattern of exercise-induced alterations of blood rheology is uncompletely understood, but increased blood fluidity may improve several steps of oxygen transfer to muscle, as clearly demonstrated in hypoxic conditions. Increasing evidence emerges from the literature, that blood fluidity is a physiological determinant of fitness.
规律运动对寿命的延长作用与冠状动脉和外周血管疾病发病率的降低有关，同时心血管危险因素也有一定改善。运动有益的代谢和血流动力学效应之间可能的联系是血液流变学，运动对其有显著影响。我们在此提出将运动的血液流变学效应描述为一种三相现象。运动的短期效应是由于液体转移和红细胞流变学特性（刚性和聚集性）改变导致血液粘度增加。血液乳酸增加、应激和急性期在这个过程中起作用。规律运动的中期效应是这些急性效应的逆转，血液流动性增加，这是由血浆量扩张（自身血液稀释）解释的，血浆量扩张降低了血浆粘度和血细胞比容。长期效应进一步改善血液流动性，与经典的训练诱导的激素和代谢改变平行。虽然身体成分、血脂模式和纤维蛋白原改善（从而降低血浆粘度），但红细胞代谢和流变学特性发生改变，聚集性和刚性降低。总体而言，这些改善反映了久坐生活方式诱导的所谓“胰岛素抵抗综合征”的逆转。由于血液流变学受损已被证明有患血管疾病的风险，可以假设运动的血液流变学效应是风险逆转的一种机制（或至少是一个标志物）。后一点需要进一步研究。运动诱导的血液流变学改变的三相模式的生理意义尚未完全理解，但血液流动性增加可能改善氧气向肌肉转移的几个步骤，这在低氧条件下已得到明确证明。文献中越来越多的证据表明，血液流动性是健康的生理决定因素。
