海军部队高强度军事训练致肾脏损伤的调查分析  

Analysis of renal injury caused by strong intensity military training in the navy

作　　者：周春华[1] 李猛[1] 余永武[1] 单毅[1] 陈洪[1] 崔艳[1] 

机构地区：[1]海军总医院肾内科,北京100037

出　　处：《解放军医学杂志》2008年第12期1488-1490,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的调查分析海军部队高强度军事训练后肾脏损伤的发生情况。方法受试对象为1 320名进行5km武装越野跑的海军部队官兵,其中新兵568人,老兵752人。训练完成后即刻留取尿液,以干化学法进行蛋白尿及血红蛋白检测;尿液离心后行红细胞镜检;ELISA法检测尿N-乙酰-β-D-氨基葡萄糖苷水解酶(NAG)和视黄醇结合蛋白(RBP)水平;以酶偶联法测定血肌酸激酶(CK)水平,以CK≥950U/L作为横纹肌溶解症诊断标准。结果训练后总体血尿发生率为2.1%,血红蛋白尿发生率为7.4%,蛋白尿阳性率为44%,尿NAG异常率为57.1%,尿RBP异常率为57.3%,且新兵均高于老兵(P<0.05);各检测项目训练结束24h后80%左右的官兵上述指标恢复正常,训练结束48h后90%左右恢复正常;以上指标复合异常(即至少有一项异常)发生率为78.2%。横纹肌溶解症发生率为0.3%,无急性肾功能衰竭出现。结论海军部队高强度军事训练后肾脏损伤发生率较高,且新、老兵之间存在明显差异,极少数官兵可发生横纹肌溶解症。Objective To investigate the incidence of renal injury caused by strong intensity military trainiug in the navy. Methods One thousand three hundred and twenty servicemen of the navy were enrolled in the present study including 568 recruits and 752 veterans. Urine protein and hemoglobin were determined using the dry chemistry method after a five-kilometer armed field race. Urine samples were collected and centrifuged for erythrocyte count under microscope after training. Retinol binding protein （RBP） and N-acetyl-β-D-glu-cosaminidase （NAG） were measured by enzyme linked immunosorbent assay （ELISA）. Detection of creatine kinase （CK） above 950U/L was assumed to be rhabdomyolysis positive. Results The average incidence of hematuria, hemoglobinuria and proteinuria was 2.1%, 7.4% and 44%, respectively, and the incidence of abnormal RBP and NAG was 57.3% and 57.1%, respectively. Significant difference in each of the indexes existed between the recruits and veterans （P〈0.05）. The indexes were restored to normal within 24 hours in 80% of the trainees and the indexes were restored to normal within 48 hours after the training in 90% of the trainees. The incidence of abnormity of two or more items of the indexes in combination was 78.2%. The incidence of rhabdomyolysis was 0.3%. No acute renal failure occurred among these servicemen. Conclusions A relatively high incidence of renal injury may be found among the naval corps after a strong intensity military training, but the incidence might be significantly different between the new recruits and veterans. Rhabdomyolysis has been found in a few naval servicemen. Regular training can decrease the incidence of renal injury.

关 键 词：军事医学 肾 创伤和损伤 

分 类 号：R82[医药卫生—临床医学]