生物钟基因基因多态性在职业紧张导致心理障碍中作用的研究

发布时间：2019-05-25 03:20

【摘要】：目的:了解新疆油田作业工人职业紧张、睡眠障碍及心理障碍的状况,探求职业紧张、睡眠障碍与心理障碍的关联,探讨生物钟基因基因多态性在职业紧张导致心理障碍中的作用。方法:以2015-2016年的新疆某地区石油管理局油田作业工人为研究对象,进行职业紧张、睡眠障碍和心理状况的调查;抽取15%作为睡眠相关激素水平和易感基因筛查测试对象,按照(性别、民族、年龄)匹配,选取睡眠障碍阳性组和睡眠障碍阴性组各154人,检测基因多态性及皮质醇、糖皮质激素、褪黑素水平,探讨生物钟基因基因多态性在职业紧张导致心理障碍中的作用及心理障碍的影响因素。结果:1)本次调查发放问卷2300份,回收有效问卷2116份,问卷回收率92.00%;2)职业紧张状况与国内常模相比,新疆油田作业工人在职业任务问卷、任务过重、任务不适、任务模糊、任务冲突、责任感、工作环境、个体紧张反应问卷、业务紧张反应、心理紧张反应、人际关系紧张反应、躯体紧张反应、个体应对资源问卷、休闲、自我保健、社会支持、理性处事上均有统计学差异(P0.05),且除任务过重、个体应对资源问卷、自我保健、社会支持、理性处事外其余各项得分均高于国内常模,男性职业任务得分高于女性,吸烟者得分高于不吸烟者(P0.05),已婚油田作业工人个体紧张反应得分高于未婚油田作业工人(P0.05);不同年龄、工种在个体应对资源得分差异具有统计学意义(P0.05),经LSD检验,年龄30~45岁与45岁得分有统计学差异(P0.05),且45岁者得分较高,输油工与司炉热注工得分上有统计学差异(P0.05),司炉热注工得分高于输油工,其余均无统计学差异,不同性别、工种、是否吸烟间职业紧张程度差异有统计学意义(P0.05);3)睡眠障碍状况PSQI总分为(6.44±3.90),睡眠障碍的发生率为36.67%,男性睡眠障碍357人,发生率为35.00%,女性睡眠障碍419人,发生率为38.23%,不同倒班情况、职称的油田作业工人睡眠障碍发生率有统计学差异(P0.05),不同职业紧张程度在PSQI总分、主观睡眠质量、睡眠障碍、日间功能障碍4项因子上有统计学差异(P0.01),经LSD检验后发现,高、中度职业紧张组这4项得分均高于低度职业紧张组,且差异有统计学意义(P0.05);4)心理障碍状况心理健康总分为(166.56±45.68)分,心理障碍阳性者为1136人,发生率为53.69%。男性心理障碍发生率为49.41%,女性心理障碍发生率为57.66%,不同性别、工龄、工种、职称、婚姻状况、是否吸烟在心理障碍阳性组与阴性组之间的差异有统计学意义(P0.05),个体紧张反应得分高者发生心理障碍的风险是得分低的1.035倍(95%CI=1.005-1.066),职业紧张水平高者发生心理障碍的风险是得分低的2.127倍(95%CI=1.156-3.912),睡眠质量差者发生心理障碍的风险是睡眠质量好者的1.684倍(95%CI=1.091-2.598),职业紧张水平、睡眠状况与心理健康三者互为相关;5)相关激素水平与睡眠障碍的关系睡眠障碍阳性组中糖皮质激素浓度低于阴性组且有统计学差异(P0.05),糖皮质激素水平与睡眠障碍呈负相关(P(27)0.05);6)生物钟基因基因多态性CLOCK基因rs1801260位点、rs6850524位点、Per3基因各基因型和等位基因在睡眠障碍阳性组和睡眠障碍阴性组中分布均有统计学差异(P0.05),调整个体紧张反应、职业紧张水平、心理障碍后,CLOCK基因rs1801260位点携带TC基因型使得睡眠障碍的发生风险降低(OR=0.412,95%CI=0.245-0.695),CLOCK基因rs6850524位点携带GC和CC基因型使得睡眠障碍的发生风险降低(OR1=0.357,95%CI1=0.245-0.695;OR2=0.317,95%CI2=0.128-0.785),CLOCK基因rs6850524位点、Per3基因各基因型和等位基因在不同心理健康状况间分布均有统计学差异(P0.05);7)心理障碍影响因素的logistic回归分析PSQI总分、皮质醇、糖皮质激素、rs1801260、rs2304672与心理障碍呈正性关联(B1=0.388,OR1=1.474;B2=0.022,OR2=1.022;B3=0.016,OR3=1.016;B4=0.949,OR4=2.584;B5=3.729,OR5=40.651),睡眠质量、睡眠时间、个体应对资源、rs6850524与心理障碍呈负性关联(B1=-0.648,OR1=0.523;B2=-0.718,OR2=0.488;B3=-0.021,OR3=0.980;B4=-0.870,OR4=0.419)结论:职业紧张水平高和睡眠质量差是心理障碍发生的危险因素;糖皮质激素可作为睡眠障碍发生的预测指标;携带CLOCK基因rs6850524位点GC和CC基因型是职业紧张导致心理障碍的保护因素。
[Abstract]:Objective: To study the situation of occupational stress, sleep disturbance and psychological disorder in the operation workers in Xinjiang oil field, and to explore the association of occupational stress, sleep disorder and psychological disorder, and to explore the role of the biological clock gene polymorphism in the psychological barrier caused by occupational stress. Methods: The study of occupational stress, sleep disturbance and psychological condition was carried out by the operation workers of oil field in a certain area of Xinjiang by 2015-2016.15% of the test subjects were screened as sleep-related hormone and susceptibility gene, and matched with (sex, ethnicity, age). 154 of the positive group and the negative group of the sleep disturbance were selected to detect the polymorphism of the gene and the level of the cortisol, the glucocorticoid and the melatonin, and to study the effect of the polymorphism of the biological clock gene on the psychological barrier caused by the occupational stress and the influence factors of the psychological barrier. Results:1) The survey and distribution questionnaire was 2300, the effective questionnaire was 2116, the recovery rate of the questionnaire was 92.00%, and the occupational stress situation was higher than that of the national norm. The work environment, the individual stress reaction questionnaire, the service tension reaction, the psychological stress reaction, the interpersonal relationship tension reaction, the physical tension reaction, the individual response to the resource questionnaire, the leisure, the self-care, the social support, the rational work have the statistical difference (P0.05), and the task is too heavy, The individual coping with the resource questionnaire, the self-care, the social support, the rational and the other scores are higher than the national norm, the male professional task score is higher than that of the female, the score of the smoker is higher than that of the non-smoker (P0.05), The scores of individual stress response of the working workers in the married oil field were higher than that of those in the unmarried oil field (P0.05). The difference of the individual coping resource scores of different ages and types of work was statistically significant (P0.05), and the scores of the age of 30-45 years and the 45-year-old were statistically different (P0.05). And the score of the 45-year-old was higher, and there was a statistical difference between the oil-losing and the heat-injection of the stoker (P0.05). The results showed that there was no significant difference in the degree of occupational stress among different sex, type of work and whether or not there was a difference in the degree of occupational stress among different sex and work types (P0.05). 3) The sleep disorder (PSQI) was divided into (6.44 and 3.90), the incidence of sleep disturbance was 36.67%, the incidence rate was 35.00%, and the female sleep disorder was 419. The incidence rate was 38.23%. There was a significant difference in the incidence of sleep disorder in the field operation workers with the professional title (P0.05). The different occupational stress levels were statistically different in the PSQI total score, the subjective sleep quality, the sleep disorder and the daytime dysfunction (P 0.01), and found after the LSD test, high, The four scores of the moderate occupational stress group were higher than that of the low-grade occupational stress group, and the difference was of statistical significance (P0.05);4) the mental health of the psychological disorder was divided into (166.56-45.68) points, the positive of the psychological disorder was 1,136, and the incidence rate was 53.69%. The incidence of psychological disorder in male was 49.41%. The incidence of psychological disorder in female was 57.66%. The difference between the positive group and the negative group of different sex, length of service, type of work, professional title and marital status was significant (P0.05). The risk of psychological disorder in the higher score of individual tension was 1.035 (95% CI = 1.005-1.066) with a low score, and the risk of the high of occupational stress was 2.127 times lower (95% CI = 1.156-3.912), and the risk of psychological disorder in the poor was 1.684-fold (95% CI = 1.091-2.598). The levels of occupational stress, sleep and mental health were related to each other;5) The concentration of glucocorticoid in the positive group of the related hormone and sleep disorder was lower than that of the negative group and there was a statistical difference (P0.05), and the level of the glucocorticoid was negatively correlated with the sleep disorder (P (27) 0.05); 6) The genetic polymorphism of the biological clock gene was rs1801260, rs6850524, and the genotype and allele of the Per3 gene were significantly different in the group of positive and negative sleep disorder (P <0.05), the individual's stress response, the level of occupational stress and the psychological barrier were adjusted. The CLOCK gene rs1801260 locus carries the TC genotype so that the risk of the sleep disorder is reduced (OR = 0.412,95% CI = 0.245-0.695), and the CLOCK gene rs6850524 site carries the GC and CC genotypes so that the risk of the sleep disorder is reduced (OR1 = 0.357,95% CI1 = 0.245-0.695, OR2 = 0.317,95% CI2 = 0.128-0.785), the CLOCK gene rs6850524 site, There was a significant difference in the distribution of the genotypes and alleles of Per3 gene in different mental health conditions (P0.05);7) Logistic regression analysis of the influence factors of psychological disorder (PSQI total score, cortisol, glucocorticoid, rs1801260, rs2304672 and psychological disorder were positively correlated (B1 = 0.388, OR1 = 1.474; B2 = 0.022, OR2 = 1.022; B3 = 0.016, OR3 = 1.016; B4 = 0.949, OR4 = 2.584; B5 = 3.729, OR5 = 40.651), sleep quality, sleep time, individual response resources, rs6850524 with a negative association with the psychological barrier (B1 =-0.648, OR1 = 0.523; B2 =-0.718, OR2 = 0.488; B3 =-0.021, OR3 = 0.980; B4 =-0.870, OR4 = 0.419): the high level of occupational stress and the difference in sleep quality are the risk factors for the occurrence of psychological disorders; Glucocorticoid can be used as a prediction index for the occurrence of sleep disturbance; the GC and CC genotypes carrying the CLOCK gene rs6850524 are the protective factors of the psychological barrier caused by occupational stress.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R135

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