职业紧张与心血管疾病危险因素的关系

目的探讨职业紧张因素、个性特征和心理性紧张反应与心血管疾病危险因素的关系.方法采用横断面研究方法对93名铁路货运调度员进行研究,使用问卷法测试职业紧张因素、个性特征和紧张反应评分,分析血清中胆固醇、甘油三酯和糖化血红蛋白浓度,测定血压和心率.结果相关分析结果表明,社会支持评分与收缩压(r=0.22)和舒张压(r=0.30)呈正相关(P＜0.05),工作满意感评分与收缩压(r=-0.37)、舒张压(r=-0.47)与血清甘油三酯浓度(r=-0.28)呈负相关(P＜0.05),自尊感评分与收缩压呈负相关(r=-0.21,P＜0.05).方差分析显示,不同社会支持因素评分组间舒张压[(78.5±13.1)、(83.6±8.2)、(88.1±12.3)、(85.8±9.8)mmHg]差异有显著性(P＜0.05),工作难度评分组间身体肥胖指数差异有显著性(P＜0.01),工作负荷评分组间收缩压[(110.1±20.5)、(112.4±12.9)、(129.1±19.7)、(125.2±15.1)mmHg]差异有显著性(P＜0.05),各紧张易感性评分组间血清中胆固醇浓度[(4.96±1.18)、(5.39±0.85)、(5.00±1.15)、(4.374±0.91)mmol/L]、收缩压[(124.9±14.4)、(129.7±13.1)、(118.4±16.4)、(133.5±23.1)mm Hg]和舒张压[(85.5±11.3)、(87.0±9.8)、(80.1±10.1)、(88.9±12.0)mmHg]差异有显著性(P＜0.05),竞争性评分组间收缩压和血清中糖化血红蛋白浓度差异有显著性(P＜0.05).逐步回归分析结果表明,工作时间需求和消极应付策略对胆固醇有较大影响(R2＞0.05),工作关系、工作难度、决定自由度、自尊感、焦虑特质和消极应付策略对吸烟预测方程的贡献较大(R2＞0.05),A型行为的竞争性因子是心率的预测因子(R2=0.06).结论工作中的社会心理紧张因素可能与某些心血管危险因素有关.

The relationship between occupational stress and cardiovascular disease risk factors

OBJECTIVE: To explore the relationship between the occupational stress and cardiovascular disease risk factors. METHODS: The subject was 93 male freight train dispatchers, the occupational stressors, personalities, and occupational strain response were measured by using questionnaires. Blood pressure, heart rate, the concentrations of the cholesterol, triglyceride, and glycosylated hemoglobin in blood serum were also measured. RESULTS: Social support score were significantly positively related to systolic pressure (r = 0.22) and diastolic pressure (r = 0.30) (P < 0.05), while job satisfaction negatively related to them and concentration of triglyceride (r = -0.37, -0.47 and -0.28 respectively, P < 0.05, P < 0.01), and self-esteem negatively to systolic pressure (r = -0.21, P < 0.05).The differences in diastolic pressure [(78.5 +/- 13.1), (83.6 +/- 8.2), (88.1 +/- 12.3), (85.8 +/- 9.8) mm Hg, P < 0.05] among groups of social support score, body mass index (BMI) (P < 0.01) among groups of job difficulty the differences in systolic pressure [(124.9 +/- 14.4), (129.7 +/- 13.1), (118.4 +/- 16.4), (133.5 +/- 23.1) mm Hg] and diastolic pressure [(85.5 +/- 11.3), (87.0 +/- 9.8), (80.1 +/- 10.1), (88.9 +/- 12.0) mm Hg] and cholesterol level in serum [(4.96 +/- 1.18), (5.39 +/- 0.85), (5.00 +/- 1.15), (4.34 +/- 0.91) mmol/L] among groups of vulnerability to stress (P < 0.05), as well as the difference in systolic pressure and glycosylated hemoglobin level in serum among groups of competition score (P < 0.05) were all statistically significant. Stepwise regression analysis showed that job time demands and negative coping affected the change of cholesterol (R(2) > 0.05); the job relation decision latitude, social support, job difficulty, personality (self-esteem and anxiety trait) and negative coping were the predictors of smoking (R(2) > 0.05). Heart rate was related to home income and competition factor of Type A Behavior (R(2) = 0.06). CONCLUSION: The psychosocial stress aspects of work may be related to some cardiovascular risk factors.