丹参液联合水分补充对高温强训陆战队员血液流变学与凝血功能的改善作用

Improvement of Hemorheology and Coagulation Function in Members of Marine Corps by Complementing Water and IVT Salviae Miltiorrhizae under High-strength Training in High Temperature Environment

目的在高温环境下强训,观察中途静脉滴注丹参液和补充水分后,海军陆战队员血液流变学和凝血系统的变化。方法 2010年某月在南海某岛屿,抽取男性海军陆战队员64名参加高温环境下负重30kg强训12h,前期和后期各6h,前期6h强训未补充水分和丹参液,后期6h静脉滴注丹参注射液并可随时口服补充水分,队员训练前、中、后各取1次血标本。检测凝血功能5项指标及血液流变学12项指标。结果①静脉滴注丹参液和补充水分前,全血低切、中切、高切粘度,血桨粘度,红细胞比积,红细胞沉降率,全血低切、中切、高切还原粘度,红细胞聚集指数,红细胞刚性指数,红细胞变性指数,凝血酶原时间,部分活化凝血酶原时间,纤维蛋白原,D-二聚体和血清纤维蛋白降解产物与强训前相比差异有统计学意义(P<0.05或P<0.01);②静脉滴注丹参液和补充水分后,D-二聚体、纤维蛋白降解产物和红细胞沉降率与强训前相比差异具有统计学意义(P<0.01);血液流变学指标,除红细胞沉降率外,凝血酶原时间、部份凝血活酶时间、纤维蛋白原与强训前相比差异无统计学意义(P>0.05)。结论供给水分可补充血容量,红细胞比积不会明显增高,注射丹参液可增强红细胞的柔软性,改善红细胞变形和聚集能力,降低纤维蛋白原含量,可防止海军陆战队员强训时高粘、高凝状态的发生。

Objective To study the changes of hemorheology and coagulation function after supplying water and IVT Salviae Miltiorrhizae in members of marine corps under high-strength training in a high temperature environment.Methods Sixty-four members were selected for high-strength training for 12 hours with 30kg loads in high temperature environment in 2010 on one island of the South China Sea.In the first 6 hours,the members were not supplied with water and Salviae Miltiorrhizae.In the second 6 hours,the members were given IVT salviae miltiorrhizae and allowed to drink water at any time.Blood samples of the marines were taken before training,in the middle of and after training.Five indexes of blood coagulation function and 12 hemorheology indexes were examined.Results ① Before supplying water and IVT salviae miltiorrhizae,many hemorheology and coagulation indexes in the marines were significantly increased compared with those before training（P0.05 or P0.01）,such as whole blood low shearing viscosity,whole blood middle shearing viscosity,whole blood high shearing viscosity,plasma viscosity,hematocrit（HCT）,erythrocyte sedimentation rate（ESR）,whole blood low shearing reduction viscosity,whole blood middle shearing reduction viscosity,whole blood high shearing reduction viscosity,erythrocyte aggregation exponent,erythrocyte rigidity exponent,erythrocyte degeneration exponent,prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,D-dimer and fibrin degradation product（FDP）.② After IVT salviae miltiorrhizae and water complement,the indexes including D-dimer,FDP and ESR were significantly different from those before training（P0.01）.There were no significant differences in PT,APTT,FIB and hemorheology（except ESR） compared with those before training（P0.05）.Conclusion Adequate water supply under high-strength training can keep HCT value in a normal level.By using salviae miltiorrhizae,the ductility of erythrocyte can be increased,the erythrocytic ability of deformability and aggregation can be improved and FIB content can be reduced in blood.These changes help to prevent the marines in high-strength training from hypercoagulale and hyperviscousof.