血管内溶血与运动员生物护照：一例阳性结果分析

Intravascular Hemolysis and Athletes Biological Passport-Comment on a Positive Data

摘要: 摘要：通过分析一例生物护照阳性判例运动员的血液检测数据，发现其网织红细胞数量及相关参数连续5个月处于较高水平，与此同时其血红蛋白含量却一直稳定地处于接近贫血的水平，这与使用禁用物质刺激造血的特征不符。结合生物护照和大量临床溶血等相关研究文献的分析，发现该运动员的生物护照检测数据符合溶血性病理生理情况。肯定了运动员发生血管内溶血并持续了较长时间，造成了生物护照检查的异常。但是，发生溶血的原因比较复杂，值得今后深入研究。因此，我们首次提出在运动员存在血管内溶血的情况下，生物护照的判定可能会出现假阳性，运动员生物护照检测需要完善，增加网织红细胞指标(ret# > 100 × 10⁹/L, ret% ≥ 2%)、血清游离血红蛋白含量来判断是否发生溶血，以避免可能的误判。

Abstract: Background: Inspecting the data of one positive Athletes Biological Passport (ABP), abnormal logic was founded: data of reticular cells were very high lasting for 5 months, but data of hemoglobin content were steadily at lower level to anemia at the same periods, this was inconformity with that hematopoiesis stimulating substances was used. Methods: Reading articles, reports and documents for establishing and confirmation of ABP, compared with the documents related to clinical hemolysis, and documents related to exercise induced hemolysis. Results: The ABP data of the case were consistence with the hemolysis according to pathological conditions of hemolysis scientifically. The reason of inducing athletes’ intravascular hemolysis was complex and needed further investigation. We first presented that athletes’ intravascular hemolysis could lead to false ABP positive, current Athletes Biological Passport needs a further complement with reticular cells pa-rameters and serum free hemoglobin content as indicators to the hemolysis.