行车人员原发性高血压高发危险因素的探讨

Analysis on essential hypertension risk factors of the high incidence in traffic officers

目的研究行车人员原发性高血压高发的危险因素,为预防和控制高血压提供依据。方法以某铁路分局在职工龄≥3年的所有男性乘警139人作为原发性高血压高发职业人群(高血压患病率41.7%,);整群抽取该铁路分局在职工龄满≥3年且年龄构成相似男性乘务员306人作为原发性高血压低发职业人群(高血压患病率21.9%),使用统一设计的健康调查表,调查高血压的常见危险因素及职业因素、职业应激、A型行为,检测血脂、血糖,比较引起原发性高血压高、低发职业人群高血压发病危险因素的差异及特点。结果(1)高血压危险因素的暴露率以及危险性在高血压高发的乘警明显高于低发的乘务员且各危险因素随着工龄的增长暴露率也明显高于低发的乘务员;(2)同样危险因素暴露水平,乘警的危险性明显高于乘务员;(3)乘警与乘务员引起高血压的危险因素及危险性存在差别,在乘警中,职业应激、体质指数、饮酒习惯、工龄是主要的危险因素,其ROR值依次是3.65、3.33、2.56和2.64;而高血脂、甘油三酯升高、胆固醇升高、年龄、和高血压家族史是乘务员高血压发生的主要危险因素,其RR值依次是4.59、3.38、3.33、2.96和2.25。结论职业社会心理、行为因素改变和增加以及长期危险因素的高暴露使血管的敏感性及反应性增高,是行车人员原发性高血压高发的重要原因。

Objective To study on essential hypertension risk factors of the high incidence in traffic officers. In order to provide evidence for prevention and control of hypertension. Methods 139 out of all male marshals who had been serving more than 3 years in a certain railway were studied as occupational crowds of high prevalence rate in essential hypertension（Prevalence rate was 41.7% ）;306 male train crew who had similar conditions in seniority and age with the marshals from two sections of this railway were studied by cluster random sampling as occupational crowds of low prevalence rate（Prevalence rate was 21.9% ）. They were surveyed the common risk factors for hypertension, occupational factors, occupational stress and type A behavior by the health questionnaire designed uniformly. Their lipids and blood glucose were detected. The cause for hypertension were compared in the differences and characteristics. Results （1） The risk factors and exposure of essential hypertension in the high incidence in the marshals were more higher than those in the low ineidenee in crew, and the exposure rate of the risk factors grew faster in the marshals than in the crew with working age. （2）By the same exposure rate of the risk factors in the marshal were more higher risk than those of the crew. （3）The risk factors and the danger lever were different in these two groups. The occupational stress , BMI, drinking habits and working age were the main risky faetors, their ROR followed by 3.65, 3.33, 2.56 and 2.64, in the marshals. Hyperlipemia, elevated triglyceride, elevated cholesterol, ages and family history of hypertension were the main risk factors, their RR followed by 4.59,3.38,3.33,2.96 and 2.25, in the crew. Conclusion The essential hypertension among people worked on the train mainly result from the change and increase of professional soeial psyehie factors and behavial factors as well as the increased sensitivity and responsibility of blood vessel formed in a long-time high exposure to the risk faetors.