Publication:

不同的運動型態對心臟損傷之研究-以血液生化指標為研究標的

單車活動目前已經成為國人休閒活動的選擇之一，更有不少人為了挑戰自己的體能極限而從事長時間又中高強度的單車活動。有文獻指出，即使是專業訓練的運動選手，在經過長時間、高強度的比賽（例如：鐵人三項或是職業級單車競賽）之後，心臟損傷相關的血液生化指標濃度皆有明顯增高，代表此運動強度對選手們來說可能會造成心臟損傷；而對於未受過訓練的一般健康民眾來說，此傷害性可能會加倍提高，只是針對這方面的相關研究卻不多；因此，本研究的目的主要是在探討經由不同的運動型態活動後，觀察一般健康民眾的生理變化，評估其心臟的損傷程度及負荷程度。本研究分別從(1) 2008第三屆鐵駱駝單車環島體驗隊活動及 (2) 2008第二屆東華盃高中暨大專校園鐵人三項徵求受測者；(1)平時無運動習慣的32名(男性24名，女性8名)受測者皆完成15天總長1114公里的單車環島活動，環島期間採自由飲食及飲水。在環島活動第一天、第五天、第十天、第十五天、及結束後第四天採集血液樣本。(2) 10名平時有運動習慣的男性受測者皆完成運動項目為750公尺游泳（限時30分鐘）、20公里自行車（限時50分鐘）、5公里路跑（限時40分鐘），比賽期間無飲水限制，並在比賽前後採集血液樣本。所有血液樣本皆分析肌紅蛋白（myoglobin）、肌酸激脢MB部分（CK-MB）、N端原腦類排鈉肽胜（NT-proBNP）、心肌肌鈣蛋白（cTnT）之濃度變化。結果顯示(1) myoglobin只有在環島的第五天濃度有顯著增高，CK-MB在環島期間顯著增加；NT-proBNP在環島第五天達到最高峰，之後則是緩慢減少，並回復到基準值。(2)myoglobin比賽後濃度顯著高於比賽前，CK-MB比賽後濃度顯著高於比賽前，NT-proBNP比賽後濃度顯著高於比賽前，cTnT比賽前後濃度皆低於最小檢測值以下。研究結果顯示從事長時間的單車環島活動和鐵人三項比賽後，對於心臟損傷方面的血液生化指標濃度會隨著運動強度及時間的增加而增加，確實對心臟造成若干負荷，但很快即能恢復至原來濃度，而且變化皆在標準範圍內，至於是否真會造成心臟的損傷，亦或是這類指標有著修復心臟受損細胞的功能，仍有待進一步的研究，但一般健康民眾從事這些運動應是無太大的健康顧慮的。

Cycling has become one of the options of leisure activities. Previous studies have demonstrated the impact of endurance exercise on cardiac damage in well-trained athletes. The effect of long-term endurance exercise on cardiac damage in untrained persons still remains unclear. The purpose of this study was to evaluate heart damage during different exercises in healthy people. These studies were achieved by: (1) 32 untrained healthy subjects (24 males and 8 females, 19-38 years old) who participated in 2008 The Ironcamel Cycling Tour of Taiwan. The tour covered 1114 km in 15 days. All subjects were in a free-feeding style during the tour. Fasting blood samples were collected in the early morning on day 1, 5, 10, 15 during the tour and 4 days after the tour. (2) 10 trained healthy males who participated in 2008 Dong Hwa University Triathlon Championships. All subjects completed for 750 meter swim (limited time : 30 minutes), 20 km bike (50 minutes), and 5 km road race (40 minutes). Water-drinking was not restricted for all subjects during the competition, and blood samples were collected before and after the race. 　　All plasma samples were analyzed for myoglobin, creatine kinase MB (CK-MB), N-terminal B-type Natriuretic Peptide (NT-proBNP) and cardiac troponin T (cTnT) concentrations. The results showed: (1) the concentration of myoglobin was significantly increased on day 5; that of CK-MB was significantly increased during the tour; and that of NT-proBNP was peaked on day 5, then was slowly reduced and returned to baseline level . (2) myoglobin, CK-MB, and NT-proBNP levels after the race were significantly higher than before. cTnT levels were detected below the minimum before and after the race. The current results suggested that biomedical markers of heart damage might be increased according to the increase in exercise intensity and time after long-term cycling tour and triathlon, but soon returned to their original levels, changes are in the standard rage. General young people who are enjoying these kinds of activities might not have the necessity to worry about big health concerns on cardiac aspects.