高强度训练对新兵横纹肌和重要脏器的影响及其干预效果

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摘要目的分析高强度训练对新兵横纹肌和重要器官的影响,评价补水、碱化尿液的干预效果。方法随机抽样某部新兵500名,随机分为常规训练组和高强度训练组。训练后4周,收集血生化、心电图进行统计分析。高强度训练组给予定时补水、碳酸氢钠片1.5 g/d碱化尿液干预治疗,观察干预前后生化指标的变化情况。结果两组横纹肌损伤率(6.67% vs.16.38%)、横纹肌溶解率(0.00% vs. 2.59%)、心肌损伤率(0.00% vs. 7.76%)、肝脏损伤率(7.50% vs. 29.31%)、肾脏损伤率(3.33% vs. 9.48%)、炎性反应发生率(19.17% vs. 43.10%,),高强度训练组均显著高于常规训练组,差异具有统计学意义(P＜0.05)。两组窦性心动过缓的发生率(2.50% vs. 6.90%)、窦性心动过速的发生率(0.83% vs. 6.03%)、左室高电压的发生率(2.50% vs. 7.76%)、短PR间期的发生率(0.00% vs. 2.59%),高强度训练组均显著高于常规训练组,差异具有统计学意义(P＜0.05)。干预前后生化指标均值Cr(80.31 μmol/L vs. 75.32 μmol/L),生化指标中位数CK(117.50 U/L vs. 88.70 U/L)、CKMB(2.09 ng/ml vs. 1.86 ng/ml) 、LDH(167.75 U/L vs. 147.75 U/L)、Myo(37.00 ng/ml vs. 31.60 ng/ml)、ALT(23.45 U/L vs. 20.00 U/L)、AST(24.25 U/L vs. 19.20 U/L),与干预前相比,反映各脏器功能的生化指标得到有效改善,差异具有统计学意义(P＜0.05)。结论高强度训练条件下新兵横纹肌和重要脏器损伤发生率更高,补水、碱化尿液可以减少横纹肌损伤和重要脏器损伤的发生率。

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关键词 ：军事训练, 横纹肌损伤, 脏器损伤, 碱化尿液

Abstract：Objective To analyze the effect of high-intensity training on striated muscle and vital organs in recruits and to evaluate the intervention effect of hydration and alkalization of urine. Methods In this study, 500 recruits from a certain troop were selected and randomly divided into a conventional training group and a high-intensity training group. Effects of high-intensity training on striated muscle and important organs of the recruits and its intervention effect 4 weeks after training, blood biochemistry and electrocardiogram were collected for statistical analysis. The high-intensity training group was given periodic hydration, sodium bicarbonate tablet 1.5 g/day alkalized urine intervention treatment, , and the changes of biochemical indexes before and after intervention were observed. Results The rates of striated muscle injury (6.67% vs. 16.38%), rhabdomyolysis (0.00% vs. 2.59%), myocardial injury (0.00% vs. 7.76%), liver injury (7.50% vs. 29.31%), kidney injury (3.33% vs. 9.48%) and inflammatory response (19.17% vs. 43.10%) were compared between the two groups. We compared the incidence rate of sinus bradycardia (2.50% vs. 6.90%), sinus tachycardia (0.83% vs. 6.03%), left ventricular high voltage (2.50% vs. 7.76%), and short PR interval (0.00% vs. 2.59%). All the indexes of the high-intensity training group were significantly higher than those of the conventional training group, and the differences were statistically significant (P<0.05).In addition, we compared the changes of biochemical measures before and after the intervention, such as mean of Cr (80.31 μmol/L vs. 75.32 μmol/L), median of CK (117.50 U/L vs. 88.70 U/L), median of CKMB (2.09 ng/ml vs. 1.86 ng/ml), median of LDH (167.75 U/L vs. 147.75 U/L), median of Myo (37.00 ng/ml vs. 31.60 ng/ml), median of ALT (23.45 U/L vs. 20.00 U/L) and median of AST (24.25 U/L vs. 19.20 U/L). Compared with indexes before the intervention, the biochemical indexes of each organ were effectively improved, and the difference was statistically significant (P<0.05). Conclusions The incidence of striated muscle injury and vital organ injury is higher in recruits under the condition of high-intensity training, and hydration and alkalization of urine can reduce the incidence of striated muscle injury and vital organ injury.

Key words： military training striated muscle injury organ injury alkalization of urine

收稿日期: 2023-03-27

ZTFLH:

R82

基金资助:解放军总医院青年成长项目(QNC19004)

通讯作者: 付振虹,E-mail:fuzhenh@126.com

作者简介: 张昕,硕士,主治医师。

引用本文:

张昕, 沈建, 宿永康, 李影, 周伯宁, 焦阳, 付振虹. 高强度训练对新兵横纹肌和重要脏器的影响及其干预效果[J]. 武警医学, 2023, 34(7): 577-581. ZHANG Xin, SHEN Jian, SU Yongkang, LI Ying, ZHOU Boning, JIAO Yang, FU Zhenhong. Effect of high-intensity training on striated muscle and vital organs of recruits and its intervention effect. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(7): 577-581.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2023/V34/I7/577

[1]	Mao H D, Li X, Liu S Y, et al. Exertional rhabdomyolysis in newly enrolled cadets of a military academy[J]. Muscle Nerve, 2021, 64(3): 336-341.
[2]	Gupta A, Thorson P, Penmatsa K R, et al. Rhabdomyolysis: revisited[J]. Ulster Med J, 2021, 90(2): 61-69.
[3]	陈欢, 何颖雪, 陈之力. 横纹肌溶解并发急性肾损伤的危险因素分析[J]. 中国中西医结合肾病杂志, 2022, 23(12): 1095-1097.
[4]	黄宇, 贺王伟, 黄峥嵘. 运动性横纹肌溶解症2例诊治分析[J]. 中国医学工程, 2017, 25(10): 106-108.
[5]	肖春明, 李超景, 方斌, 等. 军人横纹肌溶解症12例临床特点分析[J]. 人民军医, 2020, 63(11): 1088- 1089, 1101.
[6]	张文砚, 修长庆. 军事训练致横纹肌溶解症23例临床分析[J]. 临床军医杂志, 2016, 44(8): 869-870.
[7]	Backer H C, Busko M, Krause F G, et al. Exertional rhabdomyolysis and causes of elevation of creatine kinase[J]. Phys Sportsmed, 2020, 48(2): 179-185.
[8]	Arnautovic J Z, Tereziu S. Evaluation of clinical outcomes in hospitalized patients with exertional rhabdomyolysis[J]. J Am Osteopath Assoc, 2019, 119(7): 428-434.
[9]	Eichner E R. Exertional rhabdomyolysis in civilian and military populations[J]. Curr Sports Med Rep, 2020, 19(3): 99-100.
[10]	李瑜祯, 张申利. 大学生运动性横纹肌溶解症3例报告并文献复习[J]. 保健医学研究与实践, 2021, 18(5): 186-188.
[11]	Luetmer M T, Boettcher B J, Franco J M, et al. Exertional rhabdomyolysis: a retrospective population-based study[J]. Med Sci Sports Exerc, 2020, 52(3): 608-615.
[12]	龚俊, 姚宣, 马倍, 等. 创伤性横纹肌溶解综合征诊治研究进展[J]. 创伤外科杂志, 2022, 24(10): 791-794.
[13]	Peng F, Lin X, Sun L Z, et al. Exertional rhabdomyolysis in a 21-year-old healthy man resulting from lower extremity training: a case report[J]. Medicine (Baltimore), 2019, 98(28): e16244.
[14]	Al Badi A, Al Rasbi S, Alalawi A M. Exercise-induced rhabdomyolysis: a case report and literature review[J]. Cureus, 2020, 12(8): e10037.
[15]	刘嘉, 赵华昌. 运动性横纹肌溶解症防治进展[J]. 国外医药(抗生素分册), 2022, 43(5): 342-345.
[16]	Kumar R, Kumar S, Kumar A, et al. Exercise-Induced rhabdomyolysis causing acute kidney injury: a potential threat to gym lovers[J]. Cureus, 2022, 14(8): e28046.
[17]	Nolte H W, Hew-Butler T, Noakes T D, et al. Exercise-associated hyponatremic encephalopathy and exertional heatstroke in a soldier: high rates of fluid intake during exercise caused rather than prevented a fatal outcome[J]. Phys Sportsmed, 2015, 43(1): 93-8.
[18]	刘婷.横纹肌溶解症相关急性肾损伤32例临床分析[C]. 2017年第五次世界中西医结合大会论文摘要集(下册).中国中西医结合学会.2017.广东广州. 中国中西医结合学会,2017:1.
[19]	Atias-Varon D, Sherman H, Yanovich R, et al. Rhabdomyolysis after crawling military training[J]. Mil Med, 2017, 182(7): e1948-e1952.
[20]	Knapik J J, Epstein Y. Exertional heat stroke: pathophysiology, epidemiology, diagnosis, treatment, and prevention[J]. J Spec Oper Med, 2019, 19(2): 108-116.
[21]	Adhikari P, Hari A, Morel L, et al. Exertional rhabdomyolysis after crossfit exercise[J]. Cureus, 2021, 13(1): e12630.
[22]	Kim J, Lee J, Kim S, et al. Exercise-induced rhabdomyolysis mechanisms and prevention: a literature review[J]. J Sport Health Sci, 2016, 5(3): 324-333.
[23]	Carneiro A, Viana-Gomes D, Macedo-Da-Silva J, et al. Risk factors and future directions for preventing and diagnosing exertional rhabdomyolysis[J]. Neuromuscul Disord, 2021, 31(7): 583-595.
[24]	王劭亮, 陈蓉, 王明欢. 运动性横纹肌溶解症37例诊治分析[J]. 中华临床医师杂志(电子版), 2020, 14(1): 35-38.
[25]	Wu M, Wang C, Liu Z, et al. Sequential organ failure assessment score for prediction of mortality of patients with rhabdomyolysis following exertional heatstroke: a longitudinal cohort study in southern China[J]. Front Med (Lausanne), 2021, 8: 724319.
[26]	Aalborg C, Rod-Larsen C, Leiro I, et al. An increase in the number of admitted patients with exercise-induced rhabdomyolysis[J]. Tidsskr Nor Laegeforen, 2016, 136(18): 1532-1536.
[27]	Lipman G S, Gaudio F G, Eifling K P, et al. Wilderness medical society clinical practice guidelines for the prevention and treatment of heat illness: 2019 Update[J]. Wilderness Environ Med, 2019, 30(4S): S33-S46.
[28]	Scharf C, Liebchen U, Paal M, et al. Blood purification with a cytokine adsorber for the elimination of myoglobin in critically ill patients with severe rhabdomyolysis[J]. Crit Care, 2021, 25(1): 41.
[29]	刘向东, 蔡延东, 秦延军, 等. 运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓1例并文献复习[J]. 临床荟萃, 2022, 37(9): 831-833.
[30]	丛林, 朱静华, 张兆臣. 运动性横纹肌溶解症的防治[J]. 田径, 2020(12): 84,73.