2023年世界山地越野跑锦标赛上长距离越野跑对止血的影响——一项试点研究

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis Pub Date : 2025-07-01 DOI:10.1016/j.rpth.2025.102958

Wolfgang Schobersberger , Anna Katharina Tobiasch , Tobias Dünnwald , Anika Köck , Beatrix Schobersberger , Paolo Emilio Adami , Frederic Garrandes , Stephane Bermon , Günter Weiss , Christian Irsara , Benedikt Treml , Dietmar Fries

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引用次数: 0

摘要

背景：长时间剧烈运动可导致凝血标志物发生多种血栓形成前改变。由于间接测定止血和纤维蛋白溶解的变化，标准凝血试验在鉴别高凝性或低凝性方面并不可靠。相反，粘弹性测试可能会这样做。本初步研究的目的是通过在山地超级马拉松中应用粘弹性测试来评估运动引起的凝血和纤溶过程的变化。参加2023年世界山地和越野跑锦标赛的7名优秀运动员接受了检查。这条86.9公里的路线包括6500米的爬升和6920米的下降。方法分别于比赛前一天和比赛后3小时内采集静脉血。血浆凝血试验和全血粘弹性凝血试验（ClotPro）评估止血变化。结果血浆凝血试验显示凝血酶原时间延长，凝血因子(F)V、FVII、FX活性相应降低。由于内凝血因子活性（FVIII、FIX、FXI和FXII）和血管性血友病因子的增加，活化的部分凝血活素时间缩短。纤溶酶原降低，α2-抗纤溶酶和d -二聚体显著升高。最大的裂解，通过粘弹性测试检查，观察到拉伸后略有减少，而纤维蛋白聚合增加。结论：长距离比赛导致了凝血功能的显著改变，这与较高的炎症状态有关，特别是FVIII、血管性血友病因子和纤维蛋白原水平的增加。本研究中使用的粘弹性凝血监测能够反映促凝剂和抗凝剂的总和，以及促凝剂和抗纤溶剂在止血中的变化。

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Influence of long-distance trail running on blood hemostasis at the World Mountain Trail Running Championship 2023—a pilot study

Background

Severe exercise performed over longer duration can involve multiple prothrombotic alterations in blood coagulation markers. Standard coagulation tests are not robust in identifying hyper- or hypocoagulability due to indirect determination of changes in hemostasis and fibrinolysis. Conversely, viscoelastic tests might do so.

Objectives

The aim of this pilot study was to assess the exercise-induced changes in coagulatory and fibrinolytic processes by applying viscoelastic tests in a mountain ultramarathon. Seven elite athletes participating in the World Mountain and Trailrunning Championship 2023 were examined. The 86.9 km track involved 6500 m of climbing and 6920 m of descent.

Methods

Venous blood samples were taken the day prior to and within 3 hours following the competition. Plasma coagulation tests and whole blood viscoelastic coagulation tests (ClotPro) were used to assess changes in hemostasis.

Results

Plasma coagulation testing revealed prolonged prothrombin time, with correlatively decreased factor (F)V, FVII, and FX activities. As a consequence of increased intrinsic coagulation factor activities (FVIII, FIX, FXI, and FXII) and von Willebrand factor, activated partial thromboplastin time was shortened. In addition, plasminogen decreased, whereas α2-antiplasmin and D-dimer showed significant elevations. Maximal lysis, examined by viscoelastometric tests, was observed to be slightly diminished postrace, whereas fibrin polymerization increased.

Conclusion

The trail-long race generated substantial alterations in coagulation that were linked to a higher inflammatory state, with characteristic increases in FVIII, von Willebrand factor, and fibrinogen levels. Viscoelastic coagulation monitoring used in our study was able to reflect the summation of pro- and anticoagulants, as well as pro- and antifibrinolytic changes, in hemostasis.

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