Effect of noise on heart rate turbulence in workers

摘要: 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。 关键词: 噪声; 心血管系统; 窦性心率震荡 (HRT) 中图分类号: R135􀆰 8; R540􀆰 41 文献标识码: A 文章编号:1002-221X(2018)01-0003-04 DOI:10􀆰 13631/ j􀆰 cnki􀆰 zggyyx􀆰 2018􀆰 01􀆰 001 Effect of noise on heart rate turbulence in workers YAN Ruo⁃yu, ZHENG Xiao⁃hong, WANG Wei⁃hui, YAN Wan⁃yu, HUANG Jian⁃shu, ZHANG Xue⁃tao (∗. The Health Monitoring Center, Shanghai Municipal Institute of Occupational Medicine for Chemical Industry, Shanghai 200041, China) Abstract: Objective To investigate the effect of occupational noise on heart rate turbulence (HRT) in workers. Methods A total of 96 workers occupationally exposed to noise enrolled as exposed group and 95 workers without noise exposure enrolled as control group were chosen for examination of 24 h dynamic electrocardiograph (Holter) . A total of 51 workers of exposed group showed ventricular premature complexes, while in workers of control group, 49 workers showed ventricular premature complexes in records of Holter. According to two basic indices: turbulence onset(TO)and turbulence slope(TS)were obtained, the cut⁃off values for positive results in TO and TS were≥0 and≤2􀆰 5 ms / RRI. Thereby, HRT might be classified into three categories: HRT 0 (TO<0 and TS>2􀆰 5 ms / RRI), HRT 1 ( TO≥0 or TS≤2􀆰 5 ms / RRI) and HRT 2 ( TO≥0 and TS≤2􀆰 5 ms / RRI ). Results The results showed that 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 control group [ (7􀆰 23± 4􀆰 33) ms / RRI vs (9􀆰 72±5􀆰 03) ms / RRI, P<0􀆰 05) ]; additionally, the proportion of HRT 0 in exposed group was signifi⁃ cantly lower than that in control group (41􀆰 2% vs 79􀆰 6%, P<0􀆰 05), the proportions of HRT 1 and HRT 2 in exposed group were significantly higher than that in control group (39􀆰 2% vs 16􀆰 3% and 19􀆰 6% vs 4􀆰 1%, P<0􀆰 05). Conclusion The re⁃ sults indicated that HRT in noise exposed workers was significantly attenuated, which suggested that occupational noise exposure may result in impairment of cardiac autonomic nerve􀆳s activity.