馬拉松賽對急性反應分子的生理影響

The physiological effects of marathon race on acute phase reactants

目的：探討馬拉松賽對人體急性反應分子的生理影響。方法：本研究以參加2003年台北國際馬拉松賽（42.195km）之12名優秀男性長跑選手為受試對象。在賽前一週（Pre）、賽後立即（Post）和賽後第一天（D1）及第三天（D3）做血液樣本之採集，分別利用酵素聯接免疫吸附分析法（ELISA）和免疫比濁法分析（immunoturbidimetric technology）分析血液中IL-6、TNF-α、IL-1和hs-CRP，並以重複量數單因子變異數進行分析比較。結果：發現IL-6於賽後立即顯著上升3.5倍，於賽後一天降回原有水準；在IL-6回復的同時TNF-α和IL-1顯著上升，IL-1於第三天降回正常水準，而TNF-α仍是高濃度的狀態，且未回復到賽前水準。hs-CRP濃度在賽前與賽後立即時間點並無顯著變化。但在賽後1天有25倍之顯著的增加（p<.05），並於賽後的第三天下降。選手在賽後急性反應分子濃度改變幅度雖大，但仍都還在一般參考值範圍內。結論：發炎因子皆大幅上升，可見其急性反應分子延續至賽後三天，雖其數值仍於正常水準範圍之內，但濃度都處於趨近高標的水準，這可能是對免疫低下的一種回饋機制，以激動免疫變項之間的調整與適應；同時，賽後一天上升25倍的hs-CRP也警訊馬拉松賽後選手心臟血管系統可能的衝擊。

Purpose: This research was to investigate the physiological effects of Marathon Race on acute reactants. Method: This study used 12 outstanding male marathon contestants from the Taipei International Marathon Race 42.195km as subjects. Blood sample was taken at one week prior (Pre), immediately after (Post), the first day (D1) and third day after (D3) race. Enzyme-linked immunoassay assay method (ELISA) and the immunoturbidimetric technology (Beckman Coulter Image Immunochemistry system) were used for analyzing Interleukin-6 (IL-6), tumor necrosis factors-α (TNF-α), Interleukin-1 (IL-1) and high-sensitive C-reactive protein (hs-CRP). The data was analysis by repeatable ANOVA for comparison. Results: The study showed that IL-6 increased by 3.5 times immediately after the race, and returned to normal levels for the following day. TNF-α and IL-1 levels increased significantly during the recovery period of IL-6. IL-1 levels dropped to normal by the third day and TNF-α was still in high concentration, but not returned to the level before race. The hs-CRP level showed no significant discrepancy before and immediately after the race. However, hs-CRP level increased significantly by 25 times (p< .05) for one day after race, followed by a drop in the third day. Despite the wide range of the acute phase reactants density after the race, the value was still in the normal reference scope. Conclusion: All of acute phase reactants rose significantly, but its acute phase response continues for three days after the race. The density was highly near the standard although acute phase reactants' value is still in normal standard. In order to excite the variables between adjustment and adaptation, it is possible feedback mechanism to have a low immunity. Meanwhile, the hs-CRP increased by 25 times one day after the race served as a warning sign of the contestants' cardiovascular system effects.