24小時超級馬拉松對跑者血球變化及鐵代謝之影響

Changes in haematological parameters and iron metabolism associated with a 24-hour ultramarathon

本研究目的在探討24小時超級馬拉松跑後恢復期9天內其血球之變化情形。受試者為參加「2002年國際超級馬拉松暨IAU亞洲24小時錦標賽」之參賽選手，其平均年齡45.1±2.64歲、身高166.8±6.23公分、體重60.6±6.96公斤。於賽前一天、賽後即刻、賽後48小時及第9天抽血觀察血球之變化情形。結果發現紅血球、血紅素及血比容在賽後第48小時乃至第9天，其值均顯著的低於賽前值（p＜.05），而平均血球容積、平均血紅素量、平均血紅素濃度及血小板均在正常範圍內，顯示，本研究受試者於賽後第9天的運動性貧血是屬於單純紅血球數目不足，而與紅血球大小及血色素多寡無關。賽後即刻之白血球數及嗜中性球百分比均顯著的高過其他時期，且均超出正常值範圍，淋巴球總數經計算則並未減少。由此得知衰竭性的長時間運動會使白血球中的嗜中性球短暫升高，對淋巴球則無影響，且此現象於賽後48小時即消失，對免疫力的影響並不明顯。血清鐵、總鐵結合力及鐵飽和度在賽後即刻其值顯著的高於賽前值。但不論是在賽前、賽後即刻、賽後48小時乃至賽後第9天其值均在正常範圍內。總膽紅素及直接膽紅素在賽後即刻值顯著的高於賽前，因此可能有溶血之現象，但於賽後第48小時即恢復至正常範圍內。本研究結果顯示，參加24小時超級馬拉松賽對血球及免疫功能有所影響，但均屬暫時性反應，免疫功能在賽後第48小時即恢復至賽前正常值，且受試者也並無因參加比賽而有造血系統或凝血功能異常之現象發生。The purpose of this study was to investigate haematological variables and iron related changes in a 24 hours ultramarathon race. Ten male and one female participants, with mean age of 45.1 ±2.64 yr, height of 166.8 ±6.23 cm and weight of 60.6 ±6.96 kg, in the 2002 International 24h Race IAU Asia 24-Hour Championship. Blood samples were obtained from participants before, at the end of the event, after 48 hours and 9 days. Samples were analysed by standard methods for red blood cell, hemoglobin, haematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, platelets, total white cell count and differential, serum ferritin, total iron binding capacity, percentage transferrin saturation, total bilirubin and direct bilirubin. A significant decrease (p<.05) in red blood cell, hemoglobin and haematocrit was found after the race 48hr and 9 days, but the mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and platelets remained unchanged. Althoug significant rise (p<.05) in the number of white cell count and neutrophils was found after the race, the lymphocytes counted unchanged. The following variables increased at the end of the event compare to before (p<.05): serum ferritin, total iron binding capacity, percentage transferrin saturation, total bilirubin and direct bilirubin. Ultramarathon running is associated with a wide range of changes in haematological parameters, many of which are related to injury. These should not confused with indicators of disease.