职业应激与尿液中部分激素代谢物水平的关系

The relationship of occupational stress and the level of some hormone metabolites in urine

目的 探讨尿液中激素代谢物17-羟皮质类固醇（17-OHCS）、17-酮皮质类固醇（17-KS）、香草扁桃酸（VMA）及高香草酸（HVA）作为职业应激评价指标的可能性,为职业应激的识别与评价提供科学依据.方法 以方便抽样与整群抽样方法,抽取某市公安局某派出所的225名在职民警为研究对象.使用问卷调查其人口统计学特征和职业应激相关因素.采用酶联免疫吸附试验和高效液相色谱-荧光检测法对尿液中17-OHCS、17-KS、VMA和HVA浓度进行检测.应用SPSS 12.0软件对数据进行t检验、协方差分析和多因素非条件logistic回归等统计学分析.结果 工作控制和同事支持高评分组的17-OHCS水平低于低评分组,负性情绪高评分组的17-OHCS水平高于低评分组,差异均有统计学意义（P＜0.05）；工作保障高评分组的17-KS水平低于低评分组,差异有统计学意义（P＜0.05）；同事支持高评分组的VMA水平低于低评分组,非工作压力的高评分组的VMA水平高于低评分组,差异均有统计学意义（P＜0.05）；应付策略高评分组的HVA水平低于低评分组,差异有统计学意义（P＜0.05）.logistic回归分析发现,饮酒者的17-OHCS水平升高风险是不饮酒者的0.385倍,工作控制和尊重高评分组的17-OHCS水平升高风险分别是其低评分组的0.353、0.352倍,户籍警与刑警的17-OHCS水平升高风险分别是交警的3.409、3.600倍,内在投入、自尊感和每日紧张感高评分组的17-OHCS水平升高风险分别是其低评分组的3.391、2.439、2.584倍；刑警的17-KS水平升高风险是交警的2.949倍,工作控制和工作保障高评分组的17-KS水平升高风险分别是其低评分组的0.387、0.356倍；负性情绪高评分组的VMA水平升高风险是低评分组的2.643倍.结论 尿液中17-OHCS、17-KS和VMA是职业应激客观评价的潜在指标.

Objective To explore the possibility for 17-OHCS,17-KS,VMA and HVA in urine as indicators of occupational stress identification and evaluation.Methods 225 polices were investigated by using convenience sampling and cluster sampling methods,occupational stressors,strains,buffer factors and individual factors were measured by questionnaires.The urine 17-OHCS,17-KS,VMA and HVA level was tested by ELISA and high performance liquid chromatography method respectively.Results The urine 17-OHCS level of the groups with high coworker support and job control scores was lower than that of the groups with low score groups （P＜O.05）,the urine 17-OHCS level of the group with high negative affectivity score was higher than that of the group with low score group （P＜0.05）.The urine 17-KS level of the group with high job security score was lower than that of the counterparts （P＜0.05）.The urine VMA level of the group with high coworker support score was lower than that of the counterparts （P＜0.05）.The urine HVA level of the group with high coping strategy score was lower than that of counterparts （P＜0.05）.Logistic regression analysis reveled that the job control and respect were the protective factors of urine 17-OHCS level increase （OR=0.353 and 0.352 respectively）,but over-commitment,self-esteem and daily hassles were the risk factors of urine 17-OHCS with level increase （OR=3.391,2.439,and 2.584 respectively）.The risk of urine 17-KS level increase for the groups high job control and job security scores were respectively 0.387,0.356 times than that of the counterparts,the risk of urine VMA level increase for the group with high negative affectivitv score was 2.643 times than that of the counterparts.Conclusion The urine 17-OHCS,17-KS and VMA level were potential indicators for occupational stress evaluation.