职业应激与稳态应变负荷关系的研究

Relationship between job stress and allostatic load

目的探讨职业应激与稳态应变负荷（AL）之间的关系。方法采用工作内容量表（JCQ-22）对4家企业963名职工进行职业应激状况调查和健康体检,选择13个生理生化项目为AL,包括体重指数（BMI）、腰围/臀围（WHR）;收缩压（SBP）、舒张压（DBP）;血C-反应蛋白（CRP）、高密度脂蛋白（HDL）、总胆固醇（TC）/HDL、三酰甘油（TG）、糖化血红蛋白（HbAC1）、空腹胰岛素/空腹血糖、12h尿皮质醇（Col）、12h尿肾上腺素。根据各项指标的四分位数的方法对AL赋分,总计0-13分。采用α系数、协方差分析、多元逐步回归对数据进行分析（SPSS13.0）。结果问卷全部回收,合格率100%;在调整了年龄因素后AL的职业应激组（4.78±3.30）与非职业应激组（3.85±2.10）间比较,差异有显著性（F=8.38,P〈0.01）,并且两组间的BMI[（25.45±4.84）和（23.40±3.61）kg/m^2]、SBP[（122.20±21.00）和（113.5±13.87）mmHg]、DBP[（78.67±10.81）和（75.18±9.52）mmHg]、TG[（2.04±1.00）和（1.36±0.97）mmol/L]、TC/HDL[（3.51±0.54）和（3.22±0.59）]、Col[（23.06±4.70）和（19.62±9.15）μg/g]比较差异均有显著性（P〈0.05,P〈0.01或P〈0.001）。多元逐步回归结果显示工作控制和工作需求是AL的独立危险因素。结论职业应激与AL存在相关关系。

Objective To evaluate the relationship between objective health status and job stress in industrial workers. Methods Form JCQ-22 was administered to 963 employees from 4 industries to assess job stress. Biological health status was determined by the allostatic load scores with 13 components： body-mass index（ BMI）, waist-hip-ratio; systolic and diastolic blood pressure（SBP, DBP） ; plasma levels of C-reaction protein, high density lipoprotein, TC/HDL ratio, triglyceride（ TG）, prolactin, glycosylated hemoglobin, insulin/glucose; urinary cortisol and epinephrine. Score points were given for values in the high-risk quartile （0 - 13 ）. Chi-square test, covariance analysis, multiple stepwise regression were used to analyze the data （SPSS 13.0）. Results Response rate was 100 % （n = 963）. Compared with the control, job stress, SBP, DBP, TG and urinary cortisol as well as the indexes of BMI, were significantly correlated to allostatic load （ F = 8.38,P 〈 0.01 ） after being adjusted by age. Age was significantly and positively correlated to allostatic load （ F = 12. 91 ,P 〈 0. 001 ）. Multiple stepwise regression showed that job demand and job control were the independent risk factors in allostatic load. Conclusion It is found that relationship exists between job stress and allostatic load.