气郁、压力和性别与夜班医护人员胃炎发病关联的巢式病例对照研究

Association of qi depression, stress and gender with the incidence of gastritis in night shift health care workers:a nested case control study

目的研究气郁、压力和性别与夜班医护人员胃炎发病的关联。方法采用巢式病例对照研究,于2016年11月至2019年12月在辽宁省2所高等医学专业学校选取613名人员,通过内镜诊断结合问卷调查,观察从入职到随访3年内的一般基线特征、胃炎相关危险因素、胃炎分型和病理学改变。结果值夜班与随访第1年出现浅表性胃炎显著相关,与随访3年内内镜下病理改变(淋巴滤泡、出血和化生)显著相关;压力事件暴露会增加夜班医护人员患浅表性胃炎的风险,最高危险性出在值夜班第1年期间,且调节作用显著;气郁体质者和男性群体中,夜班不仅增加医护人员在随访第1年患浅表性胃炎的风险,也同时增加随访3年患萎缩性胃炎的风险;伴有气郁体质、压力事件的男性值夜班医护人员在随访第3年出现糜烂性、红斑性和其他病理改变的风险值均显著升高。结论压力事件、气郁体质和男性可增加值夜班引起的医护人员患胃炎的风险。

Objective To study the association of qi depression,pressure and gender with the incidence of gastritis in night shift medical staff.Methods From November 2016 to December 2019,a nested case-control study was conducted in 613 patients from 2 medical colleges in Liaoning Province.The general baseline characteristics,gastritis related risk factors,gastritis classification and pathological changes were observed from entry to follow-up 3 years through endoscopic diagnosis combined with questionnaire survey.Results Night shift was significantly correlated with superficial gastritis in the first year of follow-up,and with pathological changes(lymphatic follicles,bleeding and metaplasia)under endoscope in the third year of follow-up.Exposure to stress events increased the risk of superficial gastritis in night shift medical staff,and the highest risk occurred in the first year of night shift,and the moderating effect was significant.Night shift not only increased the risk of superficial gastritis at the first year of follow-up,but also increased the risk of atrophic gastritis at the third year of follow-up.The risk values of erosion,erythema and other pathological changes were significantly increased in male night shift health care workers with qi depression and stress events at the third year of follow-up.Conclusion Stressful events,qi depression,and male night shift may increase the risk of gastritis in health care workers.