噪声对作业工人窦性心率震荡的影响

Effect of noise on heart rate turbulence in workers

目的研究噪声对作业工人窦性心率震荡(heart rate turbulence,HRT)的影响。方法选取某公司动力车间单纯接触噪声的作业人员96人、不接触噪声的工作人员95人,进行24小时动态心电图检查,以动态心电图检查有室性早搏能够测量HRT的51名接触噪声的作业人员作为接触组、49名不接触噪声的工作人员作为对照组,两组人员经动态心电图分析软件得出HRT的两个指标——震荡初始(turbulence onset,TO)及震荡斜率(turbulence slope,TS),HRT阳性标准为TO≥0,TS≤2.5 ms/RRI。按照TO及TS的结果可将HRT分为三类,HRT 0类,TO<0且TS>2.5 ms/RRI;HRT 1类,TO≥0或TS≤2.5 ms/RRI;HRT 2类,TO≥0并且TS≤2.5 ms/RRI。结果 TO值接触组[(-0.01±3.18)%]较对照组[(-1.72±2.09)%]增高(P<0.05);TS值接触组[(7.23±4.33)ms/RRI]较对照组[(9.72±5.03)ms/RRI]降低(P<0.05);HRT 0在接触组中的构成比(41.2%)明显低于对照组(79.6%)(P<0.05);HRT 1、HRT 2在接触组中的构成比(39.2%、19.6%)明显高于对照组(16.3%、4.1%)(P<0.05)。结论噪声作业工人窦性心率震荡现象减弱,提示噪声接触可引起作业工人自主神经功能紊乱。

To investigate the effect of occupational noise on heart rate turbulence in workers. Methods A total of 96 workers exposed to occupational noise and 95 workers with non-noise exposure were chosen for examination of 24 h ambulatory electrocardiograph. A total of 51 workers who exposed to occupational noise showed ventricular premature complexes in records of 24 h ambulatory electrocardiograph were enrolled as exposed group. In workers with non-noise exposure,49 workers who showed ventricular premature complexes in records of 24 h ambulatory electrocardiograph were enrolled as control group. Turbulence onset （TO） and turbulence slope （TS） were determined by 24 h Holter, TO and TS were dichotomized at predefined cut points（TO≥0%,TS≤2.5ms/RRI）.HRT was classified into three categories： HRT0（both TO and TS were normal TO〈0%,TS〉2.5ms/RRI）,HRT1（TO≥0%,TS≤2.5ms/RRI） and HRT2（TO≥0%,TS≥2.5ms/RRI）. The value of above indexes was compared between two groups. Results Compared with the control group,the levels of TO in exposed group were significantly higher.[（-0.01±3.18）% VS （-1.72±2.09）%] while the level of TS was significantly lower than that in exposed group[（7.23±4.33 ）ms/RRI VS （9.72±5.03） ms/RRI] （P〈0.05）. The proportion of HRT0 in exposed group was significantly lower than that in control group（41.2% VS 79.6%） （P〈0.05）. The proportion of HRT1 and HRT2 in exposed group was significantly higher than that in control group（39.2% VS 16.3%） （19.6% VS 4.1%） （P〈0.05）.Conclusion HRT showed significantly blunted in workers exposed to noise, which suggests that occupational noise exposure can result in impairment of cardiac autonomic nerve’s activity.