职业应激对针织女工月经和性激素水平的影响

Effect of occupational stress on menses and sex hormones of female knitting workers

目的探讨职业应激对针织女工月经和性激素的影响。方法以某针织总厂415名女职工为对象，采用职业紧张测量工具调查针织女工的应激情况，同时采集处于月经来潮后3～5d和来潮前1周女工的血清样本，采用放射免疫法测定黄体酮（P）、雌二醇（E2）、睾酮（T）、催乳素（PRL）、尿促卵泡素（FSH）和黄体生成素（LH）的含量。分析不同应激程度女工的月经异常情况和激素水平。结果针织女工月经异常率为36．24％，其中月经量异常率为19．80％，月经周期异常率为14．43％；行经期异常率为11．41％，痛经现患率为1．01％。经前期综合征（PMS）现患率为29．19％。分层分析发现，非宫内节育工具（IUD）避孕者抑郁症状得分越高，月经异常率越高；IUD避孕者工作需求和日常紧张感得分越高，行经期异常率越高，无论用IUD避孕与否，日工作时间较长者行经期异常率较高；非IUD避孕组身心症状及抑郁症得分越高者月经量异常率越高；身心症状多与轮班作业可使女工PMS患病率增加；工作时间延长组女工的卵泡期血清中E2水平下降；工作需求高者卵泡期血清FSH水平下降，而黄体期血清中T水平升高；负性情绪多者黄体期血清中P水平下降。多因素分析表明，身心症状多是女工月经量异常的危险因素；正性情绪少是月经周期异常的危险因素；身心症状多、对工作资源控制程度低和负性生活事件是月经异常的危险因素；身心症状多、轮班是PMS的危险因素；日工作时间延长是行经期异常的危险因素。结论应激程度高可使女工的FSH和E2水平下降，T水平升高．从而导致月经异常率增高。

Objective To investigate the effect of occupational stress on menses and sex hormones. Methods 415 female knitting workers were investigated using the generic job stress questionnaire.Their venous blood were collected and the six sex hormones were detected by using radio-immune method. The different rate of abnormal menses and sex hormones level between different stress degree groups were analyzed. Results The abnormal rate of menses,menstrual blood volume,menstrual cycle ,menstrual period was 36,24%, 19.80%, 14.43%, 11.41% respectively. The prevalence rate of dysmenorrheal and premenstrual syndrome was 1.01% and 29.19% respectively. The more depression,the higher menses disorders in non-intrauterine device （IUD） group. The more job demands,the higher daily stress in IUD group while the longer work time, the more abnormal menstrual period in two groups. More physical symptoms and deeper depression in non-IUD group were related to higher abnormal rate of menstrual blood volume. The level of blood E2 was lower in the group of prolonged work-time than that of in normal work-time group. The increasing FSH level and decreasing T level was associated with higher job demands. Multiple factor analysis showed that physical symptom,control of resource and negative life affairs were the risk factors of menses disorder; The physical symptom was the risk factor of menstrual blood volume ; More physical symptoms, less positive feeling and shift were the risk factors of premenstrual syndrome ; Less positive feeling was the risk factor of menstrual cycle ; Prolonged daily work-time was the risk factor of menstrual period. Conclusion Higher stress degree can lead to higher FSH and E2 and lower T level, and induce menses disorder.