| 摘 要: 研究噪声对作业工人窦性心率震荡（heart rate turbulence，HRT）的影响。方法 选取某公司动力车间单纯接触噪声的作业人员96人，同时选取同一单位不接触噪声的工作人员95人，均进行24 h动态心电图检查，其中接触噪声的作业人员中动态心电图检查有室性早搏能够测量HRT的51人作为接触组，不接触噪声的工作人员中有室性早搏能测量HRT的49人作为对照组，两组人员经动态心电图分析软件得出HRT的两个指标,震荡初始(turbulence onset, TO)及震荡斜率(turbulence slope, TS)。HRT阳性标准为TO≥0，TS≤2.5 ms/RRI。按照TO及TS的结果进行HRT分类，HRT0类：TO＜0且TS＞2.5 ms/RRI；HRT1类：TO≥0或TS≤2.5 ms/RRI；HRT2类：TO≥0并且TS≤2.5 ms/RRI。比较接触组与对照组各指标的差异。结果 接触组TO值[（-0.01±3.18）%]较对照组TO值[（-1.72±2.09）%]增高（P﹤0.05）；接触组TS值[（7.23±4.33 ）ms/RRI]较对照组TS值[（9.72±5.03）ms/RRI]降低（P﹤0.05）；HRT0在接触组中的构成比（41.2%）明显低于对照组（79.6%）（P﹤0.05）；HRT1在接触组中的构成比（39.2%）明显高于对照组（16.3%）（P﹤0.05）；HRT2在接触组中的构成比（19.6%）明显高于对照组（4.1%）（P﹤0.05）。结论 噪声作业工人窦性心率震荡现象减弱，提示噪声接触可引起作业工人自主经功能紊乱。 |
| 关键词: 噪声 心血管系统 窦性心率震荡 |
|
中图分类号:
文献标识码:
|
| 基金项目: 上海市第四轮公共卫生三年行动计划重点学科建设项目（编号：15GWZK0201） |
|
| The effect of noise on heart rate turbulence in workers |
|
Yan Ruoyu*,Zheng Xiaohong, Wang Weihui, Yan Wanyu, HuangJianshu, Zhang Xuetao
|
|
The Health Monitoring Center, Shanghai Institute of Occupational Medicine for Chemical Industry, Shanghai 200041，China
|
| Abstract: To investigate the effect of occupational noise on heart rate turbulence in workers. Methods A total of 96 workers exposed to occupational noise and 95 workers with non-noise exposure were chosen for examination of 24 h ambulatory electrocardiograph. A total of 51 workers who exposed to occupational noise showed ventricular premature complexes in records of 24 h ambulatory electrocardiograph were enrolled as exposed group. In workers with non-noise exposure,49 workers who showed ventricular premature complexes in records of 24 h ambulatory electrocardiograph were enrolled as control group. Turbulence onset (TO) and turbulence slope (TS) were determined by 24 h Holter, TO and TS were dichotomized at predefined cut points(TO≥0%,TS≤2.5ms/RRI).HRT was classified into three categories: HRT0(both TO and TS were normal TO＜0%,TS＞2.5ms/RRI),HRT1(TO≥0%,TS≤2.5ms/RRI) and HRT2(TO≥0%,TS≥2.5ms/RRI). The value of above indexes was compared between two groups. Results Compared with the control group，the levels of TO in exposed group were significantly higher.[（-0.01±3.18）% VS (-1.72±2.09）%] while the level of TS was significantly lower than that in exposed group[（7.23±4.33 ）ms/RRI VS (9.72±5.03) ms/RRI] (P＜0.05). The proportion of HRT0 in exposed group was significantly lower than that in control group(41.2% VS 79.6%) (P＜0.05). The proportion of HRT1 and HRT2 in exposed group was significantly higher than that in control group(39.2% VS 16.3%) (19.6% VS 4.1%) (P＜0.05).Conclusion HRT showed significantly blunted in workers exposed to noise, which suggests that occupational noise exposure can result in impairment of cardiac autonomic nerve’s activity. |
| Keywords: noise cardiovascular system heart rate turbulence |
