血红蛋白总量在运动员生物护照兴奋剂检测中的意义

The research of hemoglobin mass on athletic biological passport for blood doping detection

目的:观察注射微量重组人促红细胞生成素(r Hu EPO)后,受试者在不同时间段血液某些参数指标的变化,为兴奋剂r Hu EPO检测运动员生物护照(ABP)提供实验依据。方法:采用单盲方式对14名健康青年男性受试者进行两个阶段随机安慰剂(n=14)和微量r Hu EPO(n=14)皮下注射,每阶段7周,每周2次。EPO注射期间给予每天口服铁剂105 mg;在注射前第7日、第一次注射后第3、10、17、24、31、38和45日、以及第7周最后一次注射后第7、14、21日分别采取静脉血测试血液基础参数(红细胞、血红蛋白浓度[Hb]、红细胞压积、网织红细胞),改良一氧化碳(CO)吸入法测试血红蛋白总量(t Hb)以及全血量(BV)、血浆量(PV)的变化情况;分析这些指标在ABP中的使用,观察总量指标和浓度指标在检测中的有效性和时效性。结果:与安慰剂组相比,14名受试者在微量r Hu EPO注射后第2周,即开始出现红细胞数量和[Hb]增加,在注射期间第5～6周达到高峰(分别增加9%和10%左右,P<0.01),一直持续到最后一次注射后3周左右; t Hb在注射后1周即开始增加,5周达到最高峰(增加10%左右,P<0.01)并一直持续到最后一次注射后1周才开始逐级恢复到注射前水平;红细胞总量在实验第5周上升至峰值,幅度为10.89%(P<0.01),总血量(BV)变化不明显,血浆量(PV)出现下降,血液浓缩。结论:7周微量r Hu EPO注射可以显著增加血液总量指标和浓度指标,其中血红蛋白总量更加敏感,可以用ABP血红蛋白总量等监测微量EPO注射;在最后一次注射结束后,血液总量指标如血红蛋白总量恢复正常,而浓度指标仍保持较高水平,可能是血液浓缩的结果。

Objective:To research the changes of blood parameters on different time points after micro-rHuEPO injection on young men and hope to provide evidences for Athletic Biological Passport(ABP)using in the detection of blood doping.Methods:Fourteen health young men were injected with micro-rHuEPO for 7 weeks,twice per one week.The subjects were treated with ferralia105 mg every day during the injections.The control group was administrated with the same volume of saline solution injection and placebo 105 mg.The blood parameters(red blood cell,hemoglobin,reticulocyte,total hemoglobin,plasma volume,etc)were tested 11 times(7 days before the first injection,3,10,17,24,31,38 and 45 days after the first injection,1,2 and 3 weeks post the seventh week of last injection).By analyzed these total and concentration parameters,hope to know the effective of two kinds of parameters on ABP.Results:The levels of RBC and[Hb]were increased sharply after two weeks of injection and reached the peak in 5-6 weeks(9-10%,P<0.01).It sustained till 3 weeks after the last injection.Total hemoglobin was increased significantly during the whole procedure of injections and reached the peak in week 5(10%,P<0.01)till 1 week after the last injection.Red blood cell volume was increased with the EPO injection and reached the peak in week 5(P<0.01),but blood volume wasn’t increased significantly.Plasma volume was decreased with EPO injection and it was hemoconcentration.Conclusion:It can enhance the total and concentration parameters through7-week micro-rHuEPO injections and the total haemoglobin is more sensitive.So t Hb can be used to detect blood doping in ABP.At the end of the last injection,the total blood parameters,such as the total hemoglobin,returned to normal,while the concentration index remained highly,possibly as a result of blood concentration.