慢性心理应激与原发性高血压病的关系研究  

Correlation between chronic psychological stress and essential hypertension

作　　者：张伟[1] 刘贺荣[1] 田如龙 王勇[1] 宋辉[1] 

机构地区：[1]宁夏医科大学公共卫生学院,宁夏银川750004 [2]宁夏吴忠市人民医院,宁夏吴忠751100

出　　处：《工业卫生与职业病》2013年第2期82-86,共5页Industrial Health and Occupational Diseases

基　　金：宁夏回族自治区科技攻关项目[2010]168号;宁夏医科大学重点孵育项目(XZ201003);宁夏卫生厅重点科研计划课题(2011028)

摘　　要：目的分析职业心理应激与原发性高血压的关系,探讨慢性心理应激在宁夏回汉民族原发性高血压病发病中的作用。方法采用1∶1配对病例对照研究方法,以宁夏某市人民医院心内科住院部以及门诊定期健康检查的企事业单位的20～60岁在职人员作为调查人群,按照纳入与排除标准,确定270名原发性高血压患者为病例组,270名健康人为对照组,进行一般情况和职业应激的问卷调查,并对研究对象进行身体检查及生化指标的检测。结果病例组人群的职业应激因素总分及工作负荷、人际关系、家庭(工作)平衡评分明显高于对照组,差异有统计学意义(t=10.497,9.688,5.846,12.707;P<0.01)。3个应激水平组间血压值比较结果显示,病例组的收缩压随应激水平的升高先下降后上升,差异有统计学意义(P<0.05),病例组的舒张压及对照组的收缩压与舒张压在3个应激水平组间比较,差异均无统计学意义(P>0.05)。多因素logistic分析结果显示,体质量指数、甘油三酯、家族史、应激因素为原发性高血压的危险因素,职业应激因素及家族史的OR值分别为2.697,4.125;95%CI分别为2.071～3.511,2.414～7.050。结论人群的血压水平受职业心理应激的影响,长期的心理应激可导致血压升高,慢性心理应激在宁夏回汉民族原发性高血压病的发病中发挥了一定的作用。Objective To analyze the correlation between occupational psychological stress and essential hypertension and to explore the effect of chronic psychological stress on the incidence of essential hypertension among Ningxia Hui and Han ethnics. Methods 1 ： 1 matched case--control study was used. Enterprises staff of 20 to 60 years old regular health check in-- patients and out-- patients of cardiology department of Ningxia People＇s Hospital were investigated. According to inclusion and exclusion standards, 270 cases of essential hypertension were taken as case group and 270 healthy staff as the control group. General and occupational stress was investigated with questionnaire. Physical examination and biochemical tests for all subjects were conducted. Results Scores of occupational stress factors, workload, personal relationship, and balance between family and work of the case group were remarkably higher than those of the control, the difference was significant（t= 10. 497,9. 688,5. 846,12. 707,P〈0.01）. Results of three stress factors showed that systolic blood pressure in case group lowered first followed by elevation when the stress levels raised, the difference was statistically significant （P〈0.05）. The difference of the diastolic blood pressure of the case group and the systolic blood pressure of the control group in three stress levels were statistically not significant （P〈0.05）. Multivariate logistic regression analysis showed that body mass index, triglycerides, family history and stress factors were the risk factors of hypertension, OR values of stress factors and family history were 2. 697 and 4. 125 respectively, 95% CI were 2. 071 to 3. 511, and 2. 414 to 7. 050. Conclusions Occupational psychological stress shows impact on blood pressure of the observed population. Long- term chronic psychological stress may induce the blood pressure to elevate. Chronic psychological stress plays a role in the incidence of essential hypertension of Ningxia Hui and Han ethnics.

关 键 词：原发性高血压 职业应激 相对危险度 

分 类 号：R135[医药卫生—劳动卫生]