职业应激与5-羟色胺2A受体基因多态性对热电厂工人抑郁症状的影响

Influence of occupational stress and 5-hydroxytryptamine 2A receptor gene polymorphisms on depression in workers in a thermal power plant

目的 探讨职业应激和5-羟色胺（5-HT）2A受体基因多态性与抑郁症状的关系.方法 2010年11月,以整群抽样的方法抽取某热电厂589名工人为研究对象.使用问卷调查其人口统计学特征和职业应激相关因素.采用聚合酶链式反应-限制性片段长度多态性技术（PCR-RFLP）检测589名工人的5-HT2A受体T102C和A-1438G位点的基因型.结果 高水平每日紧张感（0R=3.013,95％CI：1.642～5.530）、负性情绪多（OR=4.808,95％CI：2.662～8.681）、躯体需求多（0R=1.890,95％CI：1.034～3.453）和角色冲突严重（0R=1.815,95％CI：1.002～3.288）是抑郁症状的危险因素,高回报（0R=0.424,95％CI：0.226～0.796）是抑郁症状的保护因素（均P＜0.05）.有无抑郁症状组间5-HT2A受体T102C位点的基因型和等位基因的分布差异均无统计学意义（P＞0.05）;有无抑郁症状组间5-HT2A受体A-1438G位点的基因型分布差异有统计学意义（x2=9.573,P＜0.05）,但等位基因的分布差异无统计学意义（P＞0.05）.T102C位点中,高水平每日紧张感且为TC基因型或CC基因型携带者发生抑郁症状的风险分别是低水平每日紧张感且为TT基因型携带者的4.473（95％CI：1.161～17.238）、5.176（95％CI：1.367～19.593）倍,负性情绪多且为TC基因型或CC基因型携带者发生抑郁症状的风险分别是负性情绪少且为Tr基因型携带者的5.667（95％CI：1.204～26.673）、8.114（95％CI：1.747～37.677）倍;A-1438G位点中,高水平每日紧张感且为AG基因型或GG基因型携带者发生抑郁症状的风险分别是低水平每日紧张感且为AA基因型携带者的4.505（95％CI：2.215～9.162）、6.484（95％CI：2.562～16.414）倍,负性情绪多且为AG基因型或GG基因型携带者发生抑郁症状的风险分别是负性情绪少且为AA基因型携带者的4.877 （95％CI：2.326～10.223）、9.090（95％CI：3.491～23.673）倍,高回报且为AG基因型或GG基因型携带者发生抑郁症状的风险分别是低回报且为AA基因型携带者的0.152（95％CI：0.074～0.310）、0.384（95％CI：0.153～0.964）倍.结论 职业应激和抑郁症状的发生有关,且与5-HT2A受体基因多态性存在交互作用.

Objective To investigate the association of occupational stress and 5-hydroxytryptamine 2A （5-HT2A） receptor gene polymorphisms with depression.Methods In November 2010,cluster sampling was used to select 589 workers in a thermal power plant as study subjects.Questionnaires were used to investigate demographic features and occupational stressors.Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of T102C and A-1438G in 5-HT2A receptor gene in 589 workers.Results High-level daily hassles （OR =3.013,95 % CI 1.642～5.530）,more negative emotion （OR =4.808,95%CI 2.662～8.681）,more body needs（OR=1.890,95%CI 1.034～3.453）,and severe role conflict（OR=1.815,95%CI 1.002～3.288） were risk factors for depression,while high rewards （OR=0.424,95%CI 0.226～0.796） was the protective factor against depression （all P〈0.05）.There were no significant differences in T102C genotype and allele distributions between the groups with and without depression（P〉0.05）;there was a significant difference in A-1438G genotype distribution between the groups with and without depression （x2=9.573,P〈0.05）,while there was no significant difference in A-1438G allele distribution between these groups （P〉0.05）.The risk of depression in the workers with high-level daily hassles who carried TC genotype （OR=4.473,95%CI 1.161～17.238） or CC genotype （OR=5.176,95%CI 1.367～19.593） of T102C was 4.473 and 5.176 times that in those with low-level daily hassles who carried TT genotype,and the risk of depression in the workers with more negative emotions who carried TC genotype （OR=5.667,95%CI 1.204～26.673） or CC genotype （OR=8.114,95%CI 1.747～37.677） of T102C was 5.667 and 8.114 times that in those with less negative emotion who carried TT genotype.The risk of depression in the workers with high-level daily hassles who carried AG genotype （OR=4.505,95%CI 2.215～9.162） or GG genotype （OR=6.484,95%CI 2.562～16.414） of A-1438G was 4.505 and 6.484 times that in those with low-level daily hassles who carried AA genotype,and the risk of depression in the workers with more negative emotion who carried AG genotype （OR=4.877,95%CI 2.326～10.223） or GG genotype （OR=9.090,95%CI 3.491～23.673） of A-1438G was 4.877 and 9.090 times that in those with less negative emotion who carried AA genotype.The risk of depression in the workers with higher rewards who carried AG genotype （OR =0.152,95% CI 0.074～0.310） or GG genotype （OR=0.384,95% CI 0.153 ～0.964） of A-1438G was 0.152 and 0.384 times that in those with lower rewards who carried AA genotype.Conclusion Occupational stress is associated with the development of depression and interacts with 5-HT2A receptor gene polymorphisms.