CAJ | 학술논문

目的：观察长时间大负荷军事训练前后血浆生化标志物的变化，为及时发现亚临床运动性横纹肌溶解症（ exer-tional rhabdomyolysis ，ERM）及预防并发症提供依据。方法选取30名武装行军士兵，由于训练中途退出7名队员（感染、外伤等），因此最终的样本量为23名。分别测定训练前安静时、训练后即刻和次日晨血钾、血钠、血浆晶体渗透压、血浆肌酸激酶（ CK）、血浆肌红蛋白（ Mb）和血浆游离DNA（ cf-DNA）。结果血钾、血钠和血浆晶体渗透压渗透压在训练后即刻稍有增加（P＜0．05或P＜0．01），在次日晨即恢复至训练前水平。训练后即刻CK升高了58．4％，Mb升高了2倍，次日晨CK达到训练前的5倍，差异有统计学意义（P＜0．01），Mb则明显下降，但仍稍高于训练前水平，差异有统计学意义（P＜0．05）。 cf-DNA在训练后明显升高（P＜0．01），次日晨则恢复至训练前水平。结论长时间大负荷军事训练中常发生亚临床性横纹肌溶解症（subclinical exertional rhabdomyolysis ，SERM），应加强医务监督工作，监测血浆生化标志物对早期发现ERM并预防并发症具有积极意义。
목적：관찰장시간대부하군사훈련전후혈장생화표지물적변화，위급시발현아림상운동성횡문기용해증（ exer-tional rhabdomyolysis ，ERM）급예방병발증제공의거。방법선취30명무장행군사병，유우훈련중도퇴출7명대원（감염、외상등），인차최종적양본량위23명。분별측정훈련전안정시、훈련후즉각화차일신혈갑、혈납、혈장정체삼투압、혈장기산격매（ CK）、혈장기홍단백（ Mb）화혈장유리DNA（ cf-DNA）。결과혈갑、혈납화혈장정체삼투압삼투압재훈련후즉각초유증가（P＜0．05혹P＜0．01），재차일신즉회복지훈련전수평。훈련후즉각CK승고료58．4％，Mb승고료2배，차일신CK체도훈련전적5배，차이유통계학의의（P＜0．01），Mb칙명현하강，단잉초고우훈련전수평，차이유통계학의의（P＜0．05）。 cf-DNA재훈련후명현승고（P＜0．01），차일신칙회복지훈련전수평。결론장시간대부하군사훈련중상발생아림상성횡문기용해증（subclinical exertional rhabdomyolysis ，SERM），응가강의무감독공작，감측혈장생화표지물대조기발현ERM병예방병발증구유적겁의의。
Objective To study the effects of prolonged strenuous military training on plasma biological markers and provide evidence of screening subclinical exertional rhabdomyolysis ( ERM) and preventing occurrence of complication .Methods Twenty-three soldiers had a march in battle gear;and heart rate (HR), blood lactic acid (LA), blood potassium, blood sodium, plasma crys-tal osmotic pressure , creatine kinase ( CK) , myoglobin ( Mb) and cell-free plasma DNA ( cf-DNA) were determined on pre-training at rest, immediately post-training and in the next morning at rest .Results Blood potassium, blood sodium and plasma crystal osmotic pressure post-training slightly rose (P<0.05 or P<0.01) and recovered in next morning (P>0.05).CK and Mb post-training in-creased by 58.4%(P<0.05) and 200%(P<0.01),respectively, while in next morning, CK level reached 5 times that pre-training (P<0.01) and Mb reduced significantly (P<0.01) but was still higher than pre-training (P<0.05).Cf-DNA elevated obviously post-training (P<0.01) and restored to pre-training level in next morning (P>0.05).Conclusions Prolonged strenuous military training usually causes subclinical ERM and medical supervision should be enhanced before and after training .It is significant to moni-tor plasma biological markers for early detection of ERM and prevention of ERM complication .