【作者】 赵杰修；

【导师】 田野；

【作者基本信息】 北京体育大学 ， 运动人体科学， 2003， 博士

【副题名】运动和营养补充对红细胞造血生长因子和血红蛋白代谢的影响

【摘要】 运动性贫血是限制运动成绩提高的重要因素之一而倍受运动医学界的重视。关于运动性贫血的机制至今尚未完全清楚，但如何防治运动性贫血的发生一直是学术界关注的焦点。目前，关于运动性贫血机理的研究主要集中在铁代谢的方面，而对红细胞造血生长因子和血红蛋白代谢的研究极少有人涉及。本研究拟从动物实验和人体实验两方面进行运动性贫血条件下机体内血液、尿液、肝脏、肾脏、骨髓的系列相关研究。 动物实验从长期递增负荷跑台运动建立大鼠运动性贫血模型为出发点，并且在模型成功复制后随机分为运动+营养组(Ex+Ad)和运动组(Ex)再继续跑台训练，结果表明： (1)运动组的血红蛋白水平、红细胞数目和红细胞压积指标均显著低于对照组(P＜0.05)，建立了大鼠运动性贫血模型，为深入探讨运动性贫血的机理提供了更大的可能性。 (2)大鼠红细胞扫描电镜结果表明对照组(Co)大鼠血液中只有少量异常红细胞，运动+营养组大鼠血液中异常红细胞率稍高于对照组(P＞0.05)，而运动组大鼠血液中异常红细胞率则远远高于对照组(P＜0.01)。 (3)运动性贫血状态时大鼠血清粒细胞集落刺激因子(granulocyte colony-stimulating factor，G-CSF)水平有显著性变化，运动组显著高于对照组(P＜0.05)，运动+营养组与对照组没有显著性差异(P＞0.05)，而其它血清造血生长因子如粒-单核细胞集落刺激因子(granulocyte-macrophage colony-stimulating factor，GM-CSF)、白细胞介素-3(interleukin-3，IL-3)、促红细胞生成素(erythropoietin，EPO)则没有表现出组间差异性。运动组骨髓促红细胞生成素受体(erythropoietin receptor，EPOR)的基因表达量显著低于对照组(P＜0.01)，而运动+营养组与对照组之间无显著性差异(P＞0.05)。 (4)运动性贫血状态时大鼠骨髓内血红素合成代谢和珠蛋白基因表达没有显著性变化，而可以使肝脏血红素分解代谢增强和肝脏肝小叶结构不明显、肝细胞浑浊肿月长或空泡程度严重的水样变性。提示长期递增负荷跑台运动可能从肝脏血红素分解代谢角度影响机体血红蛋白水平、红细胞数目和红细胞压积。另外，运动+营养组与对照组之间无明显的不同，提示营养补充可以有效减缓运动对肝脏的损伤。 人体实验以国家贻拳道青年队和体校中长跑运动员为研究对象，根据性别和血红蛋白水平分为女性贫血组、女性对照组、男性贫血组和男性对照组，并对运动性贫血组研究对象实施营养补充计划，结果表明: (1)全血和红细胞z，3一二磷酸甘油酸(2，3一d iph。Sphoglycerate，2，3一oPG)的实验结果显示运动性贫血运动员不比正常对照运动员具有更高的2，3一DPG水平，说明血液中氧分离曲线右移的适应性角度探讨运动性贫血的发生机理不一定合适。 (2)运动性贫血运动员和正常对照运动员皆表现出运动后溶血的特点，组间并无显著性差异(P>0.05)，因此运动性溶血并不是引发运动性贫血的唯一因素。 (3)运动性贫血运动员服用杭运动性贫血复合剂不能显著影响血清EPO、T水平，提示此营养补剂可能从其它途径发挥防治运动性贫血的作用。更多还原

【Abstract】 Sports anemia is an important issue attracting the attention of the sports medicine circle for it is a major factor restricting the improvement of sports performance. So far, the mechanism of sports anemia remains uncertain. Nevertheless, effective methods in the prevention and treatment of sports anemia have been taken seriously by the academic circles. Presently, studies about sports anemia mechanism mainly focus on iron metabolism, while those about hemopoietic growth factors of erythrocyte and metabolism of hemoglobin are seldom seen. Based on animal and human experiments, this paper attempts to make a systematic study of sports anemia on blood, urine, liver, kidney and bone marrow.Animal experiment started by establishing rats model of sports model based on long-term treadmill exercise of progressive loading and rats were divided randomly into exercise+nutrition group (Ex+Ad) and exercise group (Ex) after sports anemia, then continuing treadmill training was imposed. The results of the experiment indicated:(1) The comparison made between groups reveals that in the Hb, RBC and Hct exercise group were significantly lower than control group (P<0.05). It confirms the success of establishing a rat model of sports anemia and contributes to the further research on the mechanism of sports anemia.(2) The results of scanning electron microscope of erythrocyte shape indicated that the abnormality rate was low in control group, while that in Ex+Ad group was no difference with that in control group (P>0.05) and a higher abnormality rate in Ex group (PO.01).(3) There were significant changes in serum G-CSF of rats between normal and sports anemia conditions, the index in the Ex group was higher than that in the control group (P<0.05). And there was no significant difference between Ex+Ad group and control group (P>0.05). However, no significant differences were found in GM-CSF, IL-3 and EPO. In addition, gene expression of EPOR in bone marrow wassignificantly lower in Ex group than that in control group (P<0.01), while no significant difference existed between Ex+Ad group and control group (P>0.05).(4) There were no significant changes in heme anabolism and gene expression of globin in bone marrow between normal and sports anemia conditions. However, the treadmill exercise increased the heme catabolism and caused morphological changes in liver, such as abnormity of hepatic lobes, opacity and swelling of hepatocyte or hydropic degeneration with severe vacuoles. It was demonstrated that long-term treadmill exercise of progressive loading could influence Hb, RBC, Hct by heme catabolism in liver. In addition, these differences were not found between Ex+Ad group and control group, and nutrition administration could significantly weaken the effect of exercise on liver.The subjects for human experiment were members of the Chinese youth team of kickboxing and middle-distance race team of a sport school. According to sex and results of Hb, the subjects were divided into female sports anemia group, female control group, male sports anemia and male control group. And a scheme of nutrition administration was implemented on the sports anemia groups. The results of the experiment demonstrated:(1) Experimental results of 2,3-DPG in whole blood and erythrocyte showed that the 2,3-DPG in sports anemia group was not significantly higher than control group. Therefore it is not possible to study the mechanism of sports anemia based only on the right shift in the oxygen dissociation curve of hemoglobin.(2) Haemolysis was observed after the exercise in both sports anemia group and control group, and no significant difference was found between the two groups (P>0.05). Therefore, exercise haemolysis is not the unique contributor to sports anemia.(3) Serum EPO and T levels did not change significantly in sports anemia subjects after compound dosages of anti-sports anemia administrated, which indicated that nutrition probably play the function prevention and treatment from other approaches.更多还原