中长跑运动员大强度训练后心肌功能改变及肌酸激酶的评估价值

Changes of myocardial function and the evaluative value of creatine kinase in middle and long-distance runners after high strength training

目的:分析中长跑运动员有氧与无氧训练后出现的异常高肌酸激酶水平及对运动员心肌功能的影响。方法:于2003/03选取上海市及上海体育学院田径队中长跑组二级以上运动员为观察对象。随机分为有氧组(n=12)和无氧组(n=14)。根据个人运动专长,安排相应专项训练。12名进行有氧训练项目:先进行6000m跑耐力训练,间歇8min,进行8000m速度跑,再间歇6min后,冲刺2000m;14名进行无氧训练项目:进行6000m跑耐力训练,间歇8min,进行2000m速度跑,间歇4min,再进行两次600m跑,其间间歇2min,随后进行两次200m冲刺,成绩:男24s2～28s5,女28s7～31s6,其间间歇2min。分别在训练前及运动后即刻抽静脉血,检测肌酸激酶及其他心肌功能相关指标的改变。结果:26名运动员均完成全部训练,进入结果分析。①有氧组和无氧组运动员训练前,肌酸激酶基础值均处于较高水平[(367.75±312.53),(380.64±286.45)U/L]。②运动员训练后,所选8项指标乳酸、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、碱性磷酸酶活性及肌红蛋白、血红蛋白、血糖水平均呈升高趋势。③8项指标在运动后的升高幅度,无氧组均大于有氧组。④两组运动员训练前后,乳酸、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、碱性磷酸酶活性及肌红蛋白水平改变均呈显著差异。⑤训练监测过程中,有3名运动员肌酸激酶、肌酸激酶同工酶及肌红蛋白的运动前基础值及运动后升高值均呈高度异常。结论:①不同运动项目及训练方式对心肌功能相关指标的影响存在明显差异。②联合应用乳酸、肌酸激酶、肌酸激酶同工酶、活性肌红蛋白等检测,可以更有效地监控运动员心肌损伤。③对训练后出现异常高肌酸激酶水平的运动员应及时观察肌钙蛋白水平。

AIM：To analyze the abnormal higher level of serum creatine kinase after high strength aerobic and anaerobic training in middle and long-distance runners and its influence on their myocardial function. METHODS：In March 2003,26 middle and long-distance runners,who were selected from the trek and field team of Shanghai city and Shanghai Institute of Physical Education,were randomly divided into aerobic training group （n=12） and anaerobic training group （n=14）. Every athlete was trained by using a specific training program designed according to the individual ability. Aerobic training program （n=12）： endurance training of 6000 m running, followed by a 8-minute interval, and then 8000 m velocity running, followed by a 6-minute interval, and finally 2000-m sprint. Anaerobic training program （n=14）： enduranee training of 6000 m running, followed by a 8-minute interval,and then 2000 m velocity running, followed by a 4-minute interval,and then twice 600-m running with a 2-minute interval, and finally twice 200-m sprint, The result was 24 s 2-28 s 5 for males and 28 s 7-31 s 6 for females,The venous blood sample was drawn before training and immediately after exercise respectively to detect the changes of the creatine kinase and other myocardial function related indexes. RESULTS： All the runners finished the training, and were involved in the analysis of results, ① Before training, the baltic values of serum creatine kinase were higher in both the aerobic training group and anaerobic training group [（367.75±312.53）,（380,64±286.45） U/L]. ② After training, the activities of lactic acid,lactate dehydrogenase, creatine kinase, creatine kinase isezyme and alkaline phosphatase and the levels of myohaemoglobin, hemoglobin and glucose all showed an elevated tendency. ③ The elevated ranges of all the 8 indexes after exercise were greater in the anaerobic training group than in the aerobic training group. ④ The changes of the activities of lactic acid,laetale dehydrogenase, creatine kinase, isezyme of creatine kina.se and alkaline phosphatase and the level of myohaemoglobin were significantly different in both the aerobic group than the anaerobic groups. ⑤ During the training monitoring, the basic values before exercise and the elevated values after exercise of creatine kinase, isozyme of creatine kina.se and myohaemoglobin were all highly abnormal in 3 eases. CONCLUSION： ① Different exercise and training manner have obviously different influence on the related indexes of myocardial function. ② The detections of the activities of lactic acid, creatine kinase and isozyme of creatine kinase and the level of myohaemoglobin can effectively monitor and control the myocardial injury of the runners. ③ The troponin levels should be observed promptly in the athletes with abnormally increased serum creatine kinase level after training.