运动性贫血对铁代谢与相关指标及其营养干预影响的研究

【作者】 曹建民；

【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

【摘要】 运动性贫血是指“由于运动训练或比赛造成单位容积血液中血红蛋白浓度、红细胞数值低于正常值的现象”。运动性贫血是运动员在竞技体育运动训练过程中容易出现的一种身体机能低下的状态，运动性贫血的发生和发展是影响运动员运动能力的重要因素之一，尤其是体能类项目运动员的运动水平影响极大。铁是维持生命活动的必需微量元素，其在体内的生物学作用主要表现为：通过参与血红蛋白的组成、决定氧的转运和贮存能力；构成呼吸链的重要成份，参与机体能量代谢；铁是许多酶的主要辅助因子；铁参与蛋白质的合成。故，铁与运动能力关系十分密切。但是运动性贫血的发生机制目前尚无定论，运动训练对铁代谢的影响以及铁代谢紊乱对运动性贫血发生和发展的影响仍不明晰。在运动性贫血机制研究中目前尚无运动性贫血动物模型，这也限制了对运动性贫血机制的研究。 本实验首先从建立可重复的运动性贫血动物模型入手，探讨当运动性贫血发生时其铁代谢的变化特点以及反映机体铁代谢的各种指标的变化规律，并通过抗贫血铁复合制剂的干预了解其对已发生运动性贫血大鼠的治疗效果，同时对处于运动性贫血状态的运动员的铁代谢进行深入研究，了解运动员发生运动性贫血时铁代谢及反映铁代谢指标的变化规律，并对运动性贫血运动员进行营养干预，观察其对运动员运动性贫血的治疗效果，从而探寻铁代谢在运动性贫血发生观察中的作用以及能够灵敏反映机体铁代谢状况的指标，为进一步完善运动性贫血的理论和寻找更好的防治运动性贫血的营养补剂提供依据。 本实验分为两大部分： 第一部分 动物实验 一、本实验采用5周递增负荷跑台运动可以导致大鼠血红蛋白显著下降(P＜0.05)，出现运动性贫血，在运动性贫血模型建立后进行的六周营养干预所采用的递增负荷维持了运动组大鼠的运动性贫血状态。本实验建立运动性贫血动物模型是成功的，且具备可重复性。 二、运动导致运动性贫血大鼠铁代谢紊乱，血清铁和组织铁分布发生不同的变化，血清铁、骨髓铁—功能铁明显下降，而肝脏铁、肌肉铁含量明显增加，脑组织、心肌组织和脾脏铁含量没有明显变化，具有明显的组织变化特点，这可能是运动训练大致运动性贫血发生特定时期的特征性变化。运动训练导致运动大鼠铁代谢紊乱是造成运动性贫血发生的重要因素之一。 三、运动训练导致铜代谢紊乱，血清铜和各组织铜的分布发生不同变化，铜含量与铁含量的变化不同步，且运动训练对组织铜含量的影响具有组织特点。 四、本实验对运动性贫血大鼠铁代谢指标的研究结果发现：运动训练导致运动性贫血大鼠血清铜蓝蛋白、转铁蛋白明显上升，铁蛋白明显下降；运动训练导致运动性贫血大鼠红细胞锌原卟啉含量和红细胞膜转铁蛋白受体含量明显增加；这些指标都与血清铁呈高度相关，说明血清铜蓝蛋白、铁蛋白、转铁蛋白可以反映机体铁代谢情况，而红细胞锌卟啉和红细胞膜转铁蛋白受体含量能更为准确地反映红细胞内，这些指标的有机结合能够更为准确地反映机体铁代谢状况。 五、运动训练导致运动性贫血大鼠转铁蛋白和转铁蛋白受体表达具有组织特异性，转铁蛋白受体基因表达与组织铁代谢关系密切。 2003届北京体育大学博士生学位(毕业)论文—曹建民六、抗贫血铁制剂复合营养补剂的干预可以明显增加血清铁、骨髓铁一功能铁的含量，并降低由于运动训练导致的组织铁的增加。七、贫血铁制剂复合营养补剂的干预显著降低了运动性贫血大鼠血清铜蓝蛋白、转铁蛋白、红细胞锌原叶琳和红细胞膜转铁蛋白受体含量，提高了血清铁蛋白含量，并通过对这些机体铁代谢状况指标的改善反映抗贫血铁制剂复合营养补剂对维持运动性贫血大鼠铁代谢稳定的积极作用。八、抗贫血铁制剂复合营养补剂对调节运动性贫血大鼠铜代谢紊乱具有积极意义。九、抗贫血铁复合制剂有效地提高了运动性贫血大鼠的血红蛋白水平，纠正由于运动训练造成的铁代谢紊乱，表明本实验设计的抗贫血铁复合制剂对预防运动性贫血和缺铁性贫血具有良好的作用。第二部分人体实验一、运动训练使对照组血红蛋白呈下降的趋势，抗贫血铁复合制剂促进了训练期贫血组运动员血红蛋白的回升，有利于维持和提高运动员的血红蛋白水平。二、血清铁与血红蛋白浓度呈高度正相关，运动训练导致对照各组实验后血清铁呈现下降的趋势，血红蛋白同样呈现下降的趋势，血清铁的下降是引起血红蛋白浓度降低的重要因素，提示在大负荷运动训练期间应注意铁制剂的补充。三、运动性贫血组运动员的红细胞锌叶琳浓度和红细胞转铁蛋白受体浓度实验前都显著高于对照组，血清铁蛋白降低、转铁蛋白处于较高水平、血清铜蓝蛋白浓度显著升高，说明当运动训练造成运动员运动性贫血时引起机体铁代谢紊乱，铁丢失增加而导致铁贮备下降，并引起红细胞内铁代谢紊乱。红细胞锌叶琳和转铁蛋白受体是反映红细胞内铁状况的灵敏指标;血清铁蛋白、血清转铁蛋白、血清铜蓝蛋白、红细胞锌叶琳和转铁蛋白受体与血清铁呈高度负相关，故又是评价机体铁贮备状况的良好指标。四、?更多还原

【Abstract】 Sports anemia is a phenomenon that average hemoglobin and red blood cell level under normal value respectively for sports training or contest. Sports anemia is a general state of poor sports ability during sports training. And occurrence and development of sports anemia is one main factor affecting sports ability of athletes, especially athletes of physical fitness items. Iron is the required microelement supporting life, and its biological functions in body as follow: control carrying and storing oxygen by compose hemoglobin, participate in energy metabolism by form respiratory chain, constitute some enzyme as co-factor, form synthesis of protein. At present, the mechanism of sports anemia is pending investigated, effects of sports training on iron metabolism and effects of iron metabolism turbulence on sports anemia is at a loss. Meanwhile there are not animal model of sports anemia, which limit the mechanism research of sports anemia.The experiment started establishing repeatable animal model of sports anemia, investigated the character of iron metabolism and some indexes that reflecting iron metabolism when sports anemia happened. And anti-anemia iron compound nutrition was administrated and the treatment effect and iron metabolism were observed in both animal and human, In addition, the function of iron metabolism during sports anemia and delicacy indexes reflecting iron metabolism were explored. Furthermore, the research would perfect theory of sports anemia and provide evidence for searching better nutrition method of prevent and treatment.Part one Animal experiment1. 5 weeks treadmill exercise of increase by degrees decreased blood hemoglobin level (P<0.05). Meanwhile, subsequent 6 weeks exercise maintained the condition of sports anemia in rats. The animal model of sports anemia was established successfully and possessed repeatable character.2. The exercise induced iron metabolism turbulence in the rats of sports anemia. Serum iron and tissue iron distribution had different changes such as serum iron and bone marrow iron significantly decreased, liver iron and muscle iron significantly increased, and brain iron, cardiac muscle iron and spleen iron had not significantly changes. The different changes possibly were characteristic changes during sports anemia term induced by sports training. In addition, the iron metabolism turbulence was one important factor of generation of sports anemia.3. Sports anemia caused cuprum metabolism turbulence such as distribution of serum cuprum and tissue cuprum had different changes and effects of sports training on tissue cuprum possessed position characters. And the changes of cuprum and iron were not synchronization.4. The results of iron metabolism of sports anemia in rats as follow: sports training increased serum ceruloplasmin and transferrin significantly, sports training increased erythrocyte zinc protoprophyrin and transferrin receptor of erythrocyte membrane significantly, these indexes relating with serum iron strongly indicated that serum ceruloplasmin, ferritin, transferrin could reflect iron metabolism, and erythrocyte zinc protoprophyrin and transferrin receptor levels could reflect iron metabolism in erythrocyte. And organic combination of the indexes reflect iron metabolism accurately.5. Expression of transferrin and transferrin receptor in sports anemia rats induced by sports training had position characters, and expression of transferrin receptor had significant relation with iron metabolism in tissue.6. Anti-anemia iron compound nutrition increased serum iron, bone marrow iron and retarded the development of tissue iron induced by sports training.7. Anti-anemia iron compound nutrition decreased serum ceruloplasmin and transferrin, erythrocyte zinc protoprophyrin and transferrin receptor of erythrocyte membrane significantly, and increased serum ferritin level. In addition, the indexes could reflect positive functions of anti-anemia iron compound nutrition on iron metabolism.8. An更多还原