24小时班次对急诊医生的尿尿类甲醇胺的影响:一个交叉随机试验
Frédéric Dutheil1, Alicia Fournier2, Christophe Perrier3
1CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Wittyfit, Université Clermont Auvergne, Clermont-Ferrand, France.
Scientific reports
|March 28, 2024
概括
紧急医生在24小时班 (24hS) 与14小时班 (14hS) 相比,在24小时班 (24hS) 中经历的压力更高,影响了catecholamine水平. 尿中类甲醇胺,特别是多巴胺,作为有效的压力生物标志物,表明长时间班次后的长期影响.
科学领域:
- 职业健康 职业健康 职业健康
- 生物标志物 生物标志物
- 身体生理学 身体生理学
背景情况:
- 长时间的工作轮班,特别是24小时轮班 (24hS),与急诊医生的压力增加有关.
- катехоламин是慢性压力的公认生物标志物,但它们在评估短期,多个班次的残留压力的有用性仍然未得到充分研究.
研究的目的:
- 在控制日,14小时夜班 (14hS) 和24hS期间调查急诊医生尿中甲基胺水平.
- 评估catecholamines作为短期压力的生物标志物及其在不同班次持续时间后的长期影响.
主要方法:
- 一个轮班随机试验,涉及17名急诊医生.
- 在对照和工作日间测量尿中类甲醇胺 (多巴胺,北上腺素,上腺素).
- 使用威尔科克森匹配对测试和多变量通用估计方程 (GEE) 模型进行统计分析.
主要成果:
- 与14小时和对照日相比,多巴胺水平在24小时期间显著降低,即使在24小时后的三天内,水平也没有恢复到基线.
- 在14hS和24hS期间,上腺素水平翻了一番.
- 与对照日相比,在两班的白天,上腺素水平都增加了.
- GEE模型证实了catecholamine水平,工作量和疲劳之间的关联.
结论:
- 尿甲醇胺是夜班紧急医生的急性和持续压力的有效,非侵入性生物标志物.
- 多巴胺表现出最显著的变化,表明其昼夜节律的长期中断.
- 建议减少24小时暴露,以减轻与高水平catecholamines相关的风险,包括不良心理和心血管影响.
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