热应激下武装越野后血小板活化及其参数变化与心肌损伤的相关性OA
Correlation between platelet activation and its parameters changes and myocardial injury under heat stress during armed cross-country running
目的 探讨热应激下武装越野对血小板活化及其参数的影响,分析上述变化与心肌损伤的潜在关系.方法 纳入 2023-07 至2024-07 在夏季高温环境下进行10 km武装越野的男性战士93 名.对检测受试者训练前和训练结束时的P-选择素和血小板参数,以及训练后 4 h和 16 h的肌钙蛋白I(cTnI)进行比较.根据cTnI情况分组,采用Spearman相关性分析P-选择素和血小板参数的变化(Δ)与心肌损伤的关联,运用Logistic回归分析心肌损伤的影响因素.结果 86 名战士完成训练,均未发生胸闷、心悸、持续发热等症状.训练后 4 h有 41 名出现cTnI升高,训练后 16 h cTnI明显下降,与训练后4 h相比,差异有统计学意义(P<0.05).与训练前相比,训练结束时P-选择素[261.7(198.6,355.2)vs.1060.9(808.0,2740.9)pg/ml]显著升高;血小板计数(PLT)和大血小板数量(P-LCC)明显增加,血小板压积(PCT)同步增高(P<0.05).经血容量校正,训练结束时的cPLT和cP-LCC亦高于训练前水平.根据训练后4 h cTnI是否升高,受试者分为正常组(n=45)和心肌损伤组(n=41).与正常组相比,心肌损伤组的ΔP-选择素[628.2(418.7,774.9)vs.2404.9(1885.7,2900.4)pg/ml]较大,而ΔcPLT和ΔPCT较小(P<0.05).ΔP-选择素与心肌损伤呈正相关,ΔcPLT和ΔPCT与心肌损伤呈负相关,差异均有统计学意义(P<0.05).ΔP-选择素为心肌损伤的危险因素,ΔPCT为心肌损伤的保护因素(P<0.05).结论 热应激下武装越野可引起血小板活化及其参数发生改变,以及可逆性的亚临床心肌损伤,ΔP-选择素(血小板活化程度)是心肌损伤的重要危险因素,ΔcPLT和ΔPCT与心肌损伤显著相关,ΔPCT越小,心肌损伤发生的风险越高.
Objective To explore the effects of armed cross-country running under heat stress on platelet activation and its pa-rameters,and to analyze the potential relationship between these changes and myocardial injury.Methods A total of 93 male soldiers who participated in a 10-km armed cross-country running under high-temperature conditions from July 2023 to July 2024 were included.The P-selectin and platelet parameters of the subjects were detected before and after training,as well as 4 hours and 16 hours after training.The changes of related indicators were compared.According to the cTnI levels,the subjects were grouped,and Spearman cor-relation analysis was used to analyze the changes(Δ)of P-selectin and platelet parameters and their association with myocardial inju-ry.Logistic regression was used to analyze the influencing factors of myocardial injury.Results A total of 86 soldiers completed the training without experiencing symptoms such as chest tightness,palpitations,and persistent fever.41 participants showed elevated cTnI 4 h after training,which decreased significantly 16 h after training,with a statistically significant difference compared to 4 h after train-ing(P<0.05).Compared with pre-training levels,P-selectin levels at the end of training were significantly elevated[261.7(198.6,355.2)vs.1060.9(808.0,2740.9)pg/ml](P<0.05),platelet count(PLT)and platelet-large platelet count(P-LCC)also in-creased significantly,as did platelet hematocrit(PCT)(P<0.05).After blood volume correction,cPLT and cP-LCC at the end of training remained elevated compared to pre-training levels.Subjects were divided into a normal group(n=45)and a myocardial injury group(n=41)based on whether cTnI levels were elevated 4 h after training.Compared with the normal group,the myocardial injury group had higher ΔP-selectin levels[628.2(418.7,774.9)vs.2404.9(1885.7,2900.4)pg/ml],while lower ΔcPLT and ΔPCT levels(P<0.05).ΔP-selectin was positively correlated with myo-cardial injury,while ΔcPLT and ΔPCT were negatively correlated with myocardial injury,and the differences were statistically signifi-cant(P<0.05).ΔP-selectin was a risk factor for myocardial injury,while ΔPCT was a protective factor(P<0.05).Conclusions Military training under heat stress can cause changes in platelet activation and its parameters,as well as reversible sub-clinical myocardial injury.ΔP-selectin(platelet activation degree)is an important risk factor for myocardial injury,ΔcPLT and ΔPCT are significantly correlated with myocardial injury,with lower ΔPCT levels associated with a higher risk of myocardial injury.
黎斌兵;洪绍彩;赵芬;陆艳玲;沈文雅;黄富登;贝俊杰
530003 南宁,武警广西总队医院急诊医学科530003 南宁,武警广西总队医院心血管内科530003 南宁,武警广西总队医院心血管内科530003 南宁,武警广西总队医院药局530003 南宁,武警广西总队医院心血管内科530003 南宁,武警广西总队医院检验科530003 南宁,武警广西总队医院心血管内科
医药卫生
热应激军事训练血小板活化血小板参数心肌损伤
heat stressmilitary trainingplatelet activationplatelet parametersmyocardial injury
《武警医学》 2026 (1)
48-53,6
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