新疆医务工作者职业紧张与高血压发病状况及其表观遗传学研究
发布时间：2018-08-08 20:55
【摘要】：目的:调查新疆三甲医院医务人员职业紧张水平,生理、心理健康状况等基本情况,采取病例对照研究探讨医务人员EMILIN1、SLC6A2基因多态性和高血压易感性的相关性及职业紧张交互作用在高血压人群中的致病作用,比较不同紧张程度和血压水平状态下NET基因启动子区DNA甲基化的差异,探讨表观遗传学在职业紧张与高血压相关性中的调控作用。完善新疆地区医务人员职业紧张和健康状况的流行病学资料,为制定和提高医务人员的身心健康水平、防治高血压提供科学依据。方法:1)本研究采取整群抽样抽取新疆三级甲等医院的医务人员2036人作为研究对象,进行工作紧张测量量表(Job stress survey,JSS)、工作倦怠、工作投入调查问卷和慢性非传染性疾病现患情况及行为危险因素调查问卷的现况调查;2)采用病例对照研究,应用聚合酶链式反应限制性片段长度多态法(polymerasechain reaction-restriction fragment length polymorphism,PCR-RFLP),检测确诊为高血压的200名病例组和200名对照组(匹配同性别、年龄±3岁、同民族)的基因多态性;3)采用亚硫酸氢盐克隆测序法处理基因组DNA,随后设计BSP引物进行PCR,并对PCR产物进行测序判断Cp G位点是否发生甲基化。结果:1)共发放调查问卷2036份,收回有效合格问卷1847份,回收率为90.7%。男性职业紧张各维度得分均高于女性(P0.05);不同工龄职业紧张各维度得分均不同(P0.05);工龄10-20年组职业紧张各维度得分最高(P0.05);男性在工作倦怠及各维度得分均高于女性,女性在工作投入及精力和奉献2个维度得分均高于男性(P0.05);工龄10-20年组工作倦怠中情绪耗竭、去个性化得分最高,工龄20年组工作投入中奉献得分最高(P0.05);不同科室职业紧张各维度得分均不同(P0.05);外科、妇产科组除了工作压力强度与内科、儿科组差异无统计学意义,其余职业紧张各维度得分均高于内科、儿科组(P0.05);外科、妇产组和内科、儿科组职业紧张各维度得分均高于医技组(P0.05);不同职称职业人群职业紧张各维度得分均不同,中级职称职业紧张各维度得分最高(P0.05);外科、妇产科组在工作倦怠总分、情绪耗竭2项得分均高于内科、儿科组和医技组(P0.05);不同职业紧张水平医务人员在工作倦怠总分、情绪耗竭、去个性化、个人成就感降低得分均不同(P0.05);情绪耗竭、个人成就感降低得分中,高度和中度紧张组均高于低度组紧张组(P0.05);去个性化得分中,高度紧张组得分最高(P0.05);不同职业紧张水平,医务人员在奉献得分不同(P0.05);经LSD两两比较,其中奉献的得分中,高度和中度紧张组的得分低于低度紧张组(P0.05);职业紧张各项得分与工作倦怠总分、情绪耗竭得分呈正相关,与奉献得分呈负相关(P0.01);工作紧张指数、工作压力指数、组织支持缺乏指数与去个性化得分呈正相关(P0.05);2)本次调查的医务人员中,慢病患病居前7位的依次是:颈、腰部疾病(24.6%)、慢性消化系统疾病(21.5%)、高血压(14.9%)、高血脂(10.1%)、呼吸系统疾病(8.0%)、慢性泌尿系统疾病(5.2%)、甲状腺疾病(4.1%);不同工龄组的颈、腰部疾病、慢性消化系统疾病、高血压、高血脂患病率随着工龄的增加而增加(P0.05);不同职业紧张水平组的颈、腰部疾病、慢性消化系统疾病、高血压、高血脂患病率不同(P0.05);采用两分类Logistic回归分析方法得出患有慢性消化系统疾病和高血脂是高血压患病的危险因素。工作紧张指数、工作压力指数、情绪耗竭及去个性化每增加1个单位,医务人员患高血压的可能性分别增加6.172、5.134、6.805、4.470倍;3)病例组的总胆固醇、空腹血糖均高于对照组(P0.05);病例组与对照组在高血压遗传史、被动吸烟、食盐、夜班频率、睡眠质量、职业紧张水平,差异有统计学意义(P0.05);病例组在职业紧张各维度得分均高于对照组(P0.05);4)rs2304682位点各个基因型和等位基因在病例组和对照组分布差异有统计学意义(P0.05);rs2397771位点等位基因在病例组和对照组分布差异有统计学意义(P0.05);在调整了遗传史、被动吸烟、食盐、睡眠质量、夜班频率、职业紧张水平影响后,以rs2304682位点CC基因型为参照,携带GG基因型发生高血压的风险增加(OR=2.611,95%CI:1.190-5.727);以rs2304682位点CC+CG基因型为参照,携带GG基因型发生高血压的风险增加(OR=2.432,95%CI:1.156-5.118);以rs2397771位点GG基因型为参照,携带GC基因型发生高血压的风险增加(OR=1.731,95%CI:1.057-2.835);以rs2397771位点GG基因型为参照,携带GC+CC基因型发生高血压的风险增加(OR=1.703,95%CI:1.081-2.683);5)采用非条件多因素Logistic回归分析基因-基因、基因-环境交互作用发现:rs2304682与rs2397771、rs2304682与职业紧张、rs2397771与职业紧张基于相乘模型交互作用不具有统计学意义(P0.05);采用GMDR分析基因-基因、基因-环境交互作用发现:rs2304682-rs2397771模型均具有统计学意义(P0.05);职业紧张-夜班频率,rs2397771-职业紧张-夜班频率两个模型均具有统计学意义(P0.001);其中rs2397771-职业紧张-夜班频率模型为基因-环境交互作用最佳模型;6)医务人员职业紧张-高血压-基因的关联研究提示本次调查的高血压产生与各因素间的复杂关联中,职业紧张、基因多态性与高血压产生间存在较强的显著关联,同时生活习惯等因素是间接影响因素;7)NET基因启动子区Cp G1及Cp G7各组之间经方差分析,差异有统计学意义(P0.05)。经LSD两两比较,对照组-高职业紧张组、高血压-高职业紧张组甲基化水平高于高血压-低职业紧张组,差异有统计学意义(P0.05)。其他Cp G位点均无统计学意义。结论:1)医务人员中男性、工龄在10-20年组,且外科、妇产科组职业紧张、倦怠水平最高,中级职称职业紧张水平最高;女性在工作投入及精力和奉献2个维度得分均高于男性,医务人员职业紧张状况与性别、工龄、科室及职称等个体特征相关。职业紧张越高的医务人员,职业倦怠越高;职业紧张水平越高工作投入水平越低。工龄和职业紧张可能是影响医务人员患慢性疾病的危险因素。慢性消化系统疾病、高血脂、工作紧张指数、工作压力指数、情绪耗竭及去个性化是高血压患病的危险因素。建议医院应积极干预和降低医务人员职业紧张程度,降低心理健康风险,增加应对资源,加强自我保健和修养,定期开展心理健康教育活动;2)本研究的对照组人群单核苷酸多态性(single nucleotide polymorphism,SNP)各多态性位点的基因型分布均符合新疆地区少数民族人群中的等位基因频率接近,进一步提示由于研究对象选择导致基因型在人群分布产生偏倚的可能性较小,结果可靠;EMILIN1基因rs2304682及SLC6A2基因rs2397771两个SNP位点和职业紧张、遗传史、被动吸烟、食盐、睡眠质量、夜班频率6个因素存在基因-环境交互作用。因此在预防高血压的过程中,对于存在遗传易感性的个体时,应避免外界高危因素的刺激。降低医务人员职业紧张水平,减少夜班频率可以预防易感人群高血压的发生;生活习惯可能通过职业紧张因素的影响而共同对基因多态性产生影响,进而对高血压的产生进行影响。这能够为今后医务人员心理健康及高血压产生等问题的干预提供有效干预措施建议;3)职业紧张组中高血压医务人员其NET基因启动子区Cp G1及Cp G7位点DNA甲基化水平与对照组存在差异,提示表观遗传学在职业紧张与高血压相关性中具有调控作用。
[Abstract]:Objective: To investigate the basic situation of occupational stress level, physiology and mental health status of medical staff in Xinjiang three a hospital, and to investigate the correlation between EMILIN1, SLC6A2 gene polymorphism and susceptibility to hypertension, and the pathogenicity of occupational stress interaction in high blood pressure population. The difference of DNA methylation in the promoter region of NET gene in the state of blood pressure level is used to explore the regulatory role of epigenetics in the relationship between occupational stress and hypertension. To improve the epidemiological data of occupational stress and health status of medical workers in Xinjiang, to provide science for the formulation and improvement of medical staff's physical and mental health and the prevention and treatment of hypertension. Methods: 1) in this study, 2036 medical staff of Grade A hospitals in Xinjiang three were selected as the research subjects, and the work stress scale (Job stress survey, JSS), job burnout, work input questionnaire and the current situation survey of chronic non communicable diseases and behavioral risk factors were investigated; 2) Using a case-control study, polymerasechain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genetic polymorphism of 200 cases of hypertension and 200 control groups (matching the same sex, age 3 years, the same nation); 3) the use of hydrogen sulfite salt. Cloning sequencing method treated genomic DNA, then designed BSP primers for PCR, and sequenced PCR products to determine whether Cp G loci was methylation. Results: 1) a total of 2036 questionnaires were issued and 1847 valid questionnaires were recovered. The recovery rate was higher than that of women (P0.05) in 90.7%. male occupational stress and occupational stress at different working age. The scores of all dimensions were all different (P0.05); the scores of all dimensions of occupational stress in the 10-20 year group were the highest (P0.05); the scores of men in job burnout and all dimensions were higher than those of women. The scores of women in work input and energy and dedication were higher than men (P0.05); the job burnout in 10-20 years of working age group was the highest, and the highest score of individualization was in the work age. The score of dedication in the 20 year group was the highest (P0.05); the scores of various dimensions of occupational stress in different departments were all different (P0.05); there was no statistical difference between the Department of surgery and the Department of Obstetrics and Gynecology, except for the work stress intensity and internal medicine, and the other occupational stress dimensions were higher than that of the internal department, the pediatric group (P0.05), the surgery, obstetrics and Gynecology, and the pediatrics group. The scores of all dimensions were higher than that of the medical technology group (P0.05); the scores of occupational stress in different occupational groups were all different, the scores of the occupational stress of the intermediate titles were the highest (P0.05); the 2 scores of job burnout and emotional exhaustion in the surgery, obstetrics and Gynecology group were all higher than those of the internal department, the pediatrics group and the medical skill group (P0.05); The total scores of job burnout, emotional exhaustion, individualization, and personal achievement reduction were all different (P0.05); in the scores of emotional exhaustion and personal accomplishment reduction, both high and moderate tension groups were higher than those in the low group tension group (P0.05); the high tension group scored highest (P0.05) in the individualized score (P0.05); the different occupational stress levels and medical staff were in the score. The score of dedication was different (P0.05); among the scores of LSD 22, the scores of the high and moderate tension groups were lower than the low tension group (P0.05); the scores of occupational stress were positively correlated with the total score of job burnout, the scores of emotional exhaustion, and the score of dedication (P0.01); the work stress index, the work stress index, and the organizational support were lacking. There was a positive correlation between the lack of index and depersonalization (P0.05); 2) among the medical workers in this survey, the top 7 of the chronic diseases were: neck, waist disease (24.6%), chronic digestive system disease (21.5%), hypertension (14.9%), hyperlipidemia (10.1%), respiratory system disease (8%), chronic urinary system disease (5.2%), thyroid disease (4.1%); different working age. The prevalence of cervix, lumbar disease, chronic digestive system disease, hypertension and hyperlipidemia increased with age (P0.05); the prevalence rates of neck, waist, chronic digestive system, hypertension and hyperlipidemia in different occupational stress groups were different (P0.05); the chronic digestive system was obtained by two classification Logistic regression analysis. Disease and hyperlipidemia were the risk factors of hypertension. Working stress index, working stress index, emotional exhaustion and depersonalization were increased by 1 units, the possibility of hypertension by medical staff increased 6.172,5.134,6.805,4.470 times respectively; 3) the total cholesterol and empty abdominal blood glucose in the case group were higher than those of the control group (P0.05); case group and control group were higher than those in control group. In the genetic history of hypertension, passive smoking, salt, night shift frequency, sleep quality, occupational stress level, the difference was statistically significant (P0.05); the scores of occupational stress in the case group were higher than those in the control group (P0.05); 4) the differences in the genotype and allele of the rs2304682 locus were statistically significant (P0.05) in the case group and the control group (P0.05); rs2397 The distribution difference between the 771 loci alleles in the case group and the control group was statistically significant (P0.05). After adjusting the genetic history, passive smoking, salt, sleep quality, night shift frequency, and occupational stress level, the risk of carrying GG genotype hypertension increased (OR=2.611,95%CI:1.190-5.727) with the GG genotype CC genotype (OR=2.611,95%CI:1.190-5.727); RS The 2304682 locus CC+CG genotype was used as a reference, and the risk of carrying GG genotype increased (OR=2.432,95%CI:1.156-5.118); the risk of carrying high blood pressure with the GC genotype increased (OR=1.731,95%CI:1.057-2.835) with the rs2397771 genotype GG genotype as a reference, with the GG genotype of rs2397771 site as a reference to carry the GC+CC genotypes to occur high blood. The risk of pressure increased (OR=1.703,95%CI:1.081-2.683); 5) the use of non conditional multiple factor Logistic regression analysis gene gene, gene environmental interaction found that rs2304682 and rs2397771, rs2304682 and occupational stress, rs2397771 and occupational stress based on the multiplicative model interaction did not have statistical significance (P0.05); GMDR analysis gene - base Because of gene environmental interaction, the rs2304682-rs2397771 model was statistically significant (P0.05); occupational stress - night shift frequency, rs2397771- occupational stress - night shift frequency two models were statistically significant (P0.001), and rs2397771- occupational stress - night shift rate model was the best model of gene environmental interaction; 6) medical workers The association of occupational stress - hypertension - genes suggests that there is a strong correlation between occupational stress, genetic polymorphism and hypertension, and the factors of living habits are indirect factors, and 7) the NET gene promoter region Cp G1 and Cp G7 between each group. Difference analysis, the difference was statistically significant (P0.05). Compared with LSD 22, the control group, high occupational stress group, high hypertension and high occupational stress group was higher than hypertension and low occupational stress group, the difference was statistically significant (P0.05). The other Cp G loci were not statistically significant. Conclusion: 1) the male in the medical staff was in the 10-20 year group, and the surgery was in the surgery. In the obstetrics and Gynecology group, the level of occupational stress and burnout was the highest and the level of occupational stress was the highest. The scores of 2 dimensions of work input, energy and dedication were all higher than that of men. The occupational stress of medical staff was related to the individual characteristics of sex, work age, department and title. The higher the occupational stress, the higher the job burnout, and the occupational stress. The higher the level of Zhang Shuiping's work, the lower the level of work. Working age and occupational stress may be the risk factors that affect the medical staff with chronic diseases. Chronic digestive system diseases, hyperlipidemia, work stress index, work stress index, emotional exhaustion and depersonalization are risk factors for hypertension. It is suggested that hospitals should actively intervene and reduce medical workers. The degree of occupational stress, reducing the risk of mental health, increasing the coping resources, strengthening self health care and cultivation, carrying out mental health education regularly; 2) the genotype distribution of the polymorphisms of single nucleotide polymorphisms (single nucleotide polymorphism, SNP) in the control group of this study conforms to the minority ethnic groups in Xinjiang region. The allele frequency is close, and further hints that the possibility of genetic bias in the population distribution is smaller and the result is reliable. The two SNP loci of the EMILIN1 gene rs2304682 and SLC6A2 gene rs2397771, the genetic history, the passive smoking, the salt eating, the sleep quality, and the night shift frequency exist in the gene environment. Therefore, in the process of prevention of hypertension, for individuals with genetic susceptibility, it is necessary to avoid the stimulation of high risk factors of the outside world. Reducing the occupational stress level and reducing the frequency of night shift can prevent the occurrence of hypertension in the susceptible population; life habits may pass through the influence of occupational stress factors and share more genes. The influence of the state of state on the production of hypertension, which can provide effective intervention suggestions for the intervention of medical workers' mental health and hypertension and other problems in the future. 3) the level of Cp G1 and Cp G7 site DNA methylation in the NET gene promoter region of the occupational stress group is different from that of the control group. Epigenetics plays a regulatory role in the relationship between occupational stress and hypertension.
【学位授予单位】：新疆医科大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R544.1
本文编号：2173014
[Abstract]:Objective: To investigate the basic situation of occupational stress level, physiology and mental health status of medical staff in Xinjiang three a hospital, and to investigate the correlation between EMILIN1, SLC6A2 gene polymorphism and susceptibility to hypertension, and the pathogenicity of occupational stress interaction in high blood pressure population. The difference of DNA methylation in the promoter region of NET gene in the state of blood pressure level is used to explore the regulatory role of epigenetics in the relationship between occupational stress and hypertension. To improve the epidemiological data of occupational stress and health status of medical workers in Xinjiang, to provide science for the formulation and improvement of medical staff's physical and mental health and the prevention and treatment of hypertension. Methods: 1) in this study, 2036 medical staff of Grade A hospitals in Xinjiang three were selected as the research subjects, and the work stress scale (Job stress survey, JSS), job burnout, work input questionnaire and the current situation survey of chronic non communicable diseases and behavioral risk factors were investigated; 2) Using a case-control study, polymerasechain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genetic polymorphism of 200 cases of hypertension and 200 control groups (matching the same sex, age 3 years, the same nation); 3) the use of hydrogen sulfite salt. Cloning sequencing method treated genomic DNA, then designed BSP primers for PCR, and sequenced PCR products to determine whether Cp G loci was methylation. Results: 1) a total of 2036 questionnaires were issued and 1847 valid questionnaires were recovered. The recovery rate was higher than that of women (P0.05) in 90.7%. male occupational stress and occupational stress at different working age. The scores of all dimensions were all different (P0.05); the scores of all dimensions of occupational stress in the 10-20 year group were the highest (P0.05); the scores of men in job burnout and all dimensions were higher than those of women. The scores of women in work input and energy and dedication were higher than men (P0.05); the job burnout in 10-20 years of working age group was the highest, and the highest score of individualization was in the work age. The score of dedication in the 20 year group was the highest (P0.05); the scores of various dimensions of occupational stress in different departments were all different (P0.05); there was no statistical difference between the Department of surgery and the Department of Obstetrics and Gynecology, except for the work stress intensity and internal medicine, and the other occupational stress dimensions were higher than that of the internal department, the pediatric group (P0.05), the surgery, obstetrics and Gynecology, and the pediatrics group. The scores of all dimensions were higher than that of the medical technology group (P0.05); the scores of occupational stress in different occupational groups were all different, the scores of the occupational stress of the intermediate titles were the highest (P0.05); the 2 scores of job burnout and emotional exhaustion in the surgery, obstetrics and Gynecology group were all higher than those of the internal department, the pediatrics group and the medical skill group (P0.05); The total scores of job burnout, emotional exhaustion, individualization, and personal achievement reduction were all different (P0.05); in the scores of emotional exhaustion and personal accomplishment reduction, both high and moderate tension groups were higher than those in the low group tension group (P0.05); the high tension group scored highest (P0.05) in the individualized score (P0.05); the different occupational stress levels and medical staff were in the score. The score of dedication was different (P0.05); among the scores of LSD 22, the scores of the high and moderate tension groups were lower than the low tension group (P0.05); the scores of occupational stress were positively correlated with the total score of job burnout, the scores of emotional exhaustion, and the score of dedication (P0.01); the work stress index, the work stress index, and the organizational support were lacking. There was a positive correlation between the lack of index and depersonalization (P0.05); 2) among the medical workers in this survey, the top 7 of the chronic diseases were: neck, waist disease (24.6%), chronic digestive system disease (21.5%), hypertension (14.9%), hyperlipidemia (10.1%), respiratory system disease (8%), chronic urinary system disease (5.2%), thyroid disease (4.1%); different working age. The prevalence of cervix, lumbar disease, chronic digestive system disease, hypertension and hyperlipidemia increased with age (P0.05); the prevalence rates of neck, waist, chronic digestive system, hypertension and hyperlipidemia in different occupational stress groups were different (P0.05); the chronic digestive system was obtained by two classification Logistic regression analysis. Disease and hyperlipidemia were the risk factors of hypertension. Working stress index, working stress index, emotional exhaustion and depersonalization were increased by 1 units, the possibility of hypertension by medical staff increased 6.172,5.134,6.805,4.470 times respectively; 3) the total cholesterol and empty abdominal blood glucose in the case group were higher than those of the control group (P0.05); case group and control group were higher than those in control group. In the genetic history of hypertension, passive smoking, salt, night shift frequency, sleep quality, occupational stress level, the difference was statistically significant (P0.05); the scores of occupational stress in the case group were higher than those in the control group (P0.05); 4) the differences in the genotype and allele of the rs2304682 locus were statistically significant (P0.05) in the case group and the control group (P0.05); rs2397 The distribution difference between the 771 loci alleles in the case group and the control group was statistically significant (P0.05). After adjusting the genetic history, passive smoking, salt, sleep quality, night shift frequency, and occupational stress level, the risk of carrying GG genotype hypertension increased (OR=2.611,95%CI:1.190-5.727) with the GG genotype CC genotype (OR=2.611,95%CI:1.190-5.727); RS The 2304682 locus CC+CG genotype was used as a reference, and the risk of carrying GG genotype increased (OR=2.432,95%CI:1.156-5.118); the risk of carrying high blood pressure with the GC genotype increased (OR=1.731,95%CI:1.057-2.835) with the rs2397771 genotype GG genotype as a reference, with the GG genotype of rs2397771 site as a reference to carry the GC+CC genotypes to occur high blood. The risk of pressure increased (OR=1.703,95%CI:1.081-2.683); 5) the use of non conditional multiple factor Logistic regression analysis gene gene, gene environmental interaction found that rs2304682 and rs2397771, rs2304682 and occupational stress, rs2397771 and occupational stress based on the multiplicative model interaction did not have statistical significance (P0.05); GMDR analysis gene - base Because of gene environmental interaction, the rs2304682-rs2397771 model was statistically significant (P0.05); occupational stress - night shift frequency, rs2397771- occupational stress - night shift frequency two models were statistically significant (P0.001), and rs2397771- occupational stress - night shift rate model was the best model of gene environmental interaction; 6) medical workers The association of occupational stress - hypertension - genes suggests that there is a strong correlation between occupational stress, genetic polymorphism and hypertension, and the factors of living habits are indirect factors, and 7) the NET gene promoter region Cp G1 and Cp G7 between each group. Difference analysis, the difference was statistically significant (P0.05). Compared with LSD 22, the control group, high occupational stress group, high hypertension and high occupational stress group was higher than hypertension and low occupational stress group, the difference was statistically significant (P0.05). The other Cp G loci were not statistically significant. Conclusion: 1) the male in the medical staff was in the 10-20 year group, and the surgery was in the surgery. In the obstetrics and Gynecology group, the level of occupational stress and burnout was the highest and the level of occupational stress was the highest. The scores of 2 dimensions of work input, energy and dedication were all higher than that of men. The occupational stress of medical staff was related to the individual characteristics of sex, work age, department and title. The higher the occupational stress, the higher the job burnout, and the occupational stress. The higher the level of Zhang Shuiping's work, the lower the level of work. Working age and occupational stress may be the risk factors that affect the medical staff with chronic diseases. Chronic digestive system diseases, hyperlipidemia, work stress index, work stress index, emotional exhaustion and depersonalization are risk factors for hypertension. It is suggested that hospitals should actively intervene and reduce medical workers. The degree of occupational stress, reducing the risk of mental health, increasing the coping resources, strengthening self health care and cultivation, carrying out mental health education regularly; 2) the genotype distribution of the polymorphisms of single nucleotide polymorphisms (single nucleotide polymorphism, SNP) in the control group of this study conforms to the minority ethnic groups in Xinjiang region. The allele frequency is close, and further hints that the possibility of genetic bias in the population distribution is smaller and the result is reliable. The two SNP loci of the EMILIN1 gene rs2304682 and SLC6A2 gene rs2397771, the genetic history, the passive smoking, the salt eating, the sleep quality, and the night shift frequency exist in the gene environment. Therefore, in the process of prevention of hypertension, for individuals with genetic susceptibility, it is necessary to avoid the stimulation of high risk factors of the outside world. Reducing the occupational stress level and reducing the frequency of night shift can prevent the occurrence of hypertension in the susceptible population; life habits may pass through the influence of occupational stress factors and share more genes. The influence of the state of state on the production of hypertension, which can provide effective intervention suggestions for the intervention of medical workers' mental health and hypertension and other problems in the future. 3) the level of Cp G1 and Cp G7 site DNA methylation in the NET gene promoter region of the occupational stress group is different from that of the control group. Epigenetics plays a regulatory role in the relationship between occupational stress and hypertension.
【学位授予单位】：新疆医科大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R544.1
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