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探寻日本老年出租车司机心血管事件的预防措施——夜班日心血管危险因素的日节律

Searching for preventive measures of cardiovascular events in aged Japanese taxi drivers--the daily rhythm of cardiovascular risk factors during a night duty day.

作者信息

Hattori M, Azami Y

机构信息

Johoku Hospital, Kanazawa, Japan.

出版信息

J Hum Ergol (Tokyo). 2001 Dec;30(1-2):321-6.

Abstract

Previous studies have shown that Japanese taxi drivers are exposed to more risk factors and have a higher mortality rate due to cardiovascular disease than other occupational groups. We investigated the effect of night taxi driving with a view to preventing acute events of cardiovascular disease among aged taxi drivers. Twenty-nine taxi drivers (41-67 years old) were examined for urine normetanephrine/creatinine, von Willebrand factor, anti-thrombin III, t-plasminogen activator-plasminogen activator inhibitor 1-complex, hematocrit, blood glucose and blood pressure in the morning and at midnight during a duty day and in the following morning. At the same time, the blood pressure and blood glucose of 46 taxi drivers (43-67 years old) in the morning after a night duty with little sleep and in the morning after daytime work and subsequent night sleep were compared. The results obtained indicate that the aggravation of sympathetic nervous system functions with disturbed circadian rhythms, increased blood coagulation and blood concentration, endothelial injury and the elevation of blood glucose at midnight or the next morning were induced by their night work. These conditions are supposed to favour acute vascular events in aged taxi drivers. Preventive measures considered include social support for anticoagulant food and water intake, short exercise and walking as well as taking a rest and a nap during night work.

摘要

先前的研究表明,与其他职业群体相比,日本出租车司机面临更多风险因素,心血管疾病死亡率更高。我们调查了夜间出租车驾驶的影响,以期预防老年出租车司机发生心血管疾病急性事件。对29名出租车司机(41 - 67岁)在工作日的早晨、午夜以及次日早晨进行了尿去甲肾上腺素/肌酐、血管性血友病因子、抗凝血酶III、组织型纤溶酶原激活剂 - 纤溶酶原激活剂抑制剂1复合物、血细胞比容、血糖和血压检测。同时,比较了46名出租车司机(43 - 67岁)在睡眠不足的夜间值班后早晨以及白天工作和随后夜间睡眠后早晨的血压和血糖。所得结果表明,他们的夜间工作会导致昼夜节律紊乱时交感神经系统功能加重、血液凝固和血浓度增加、内皮损伤以及午夜或次日早晨血糖升高。这些情况被认为有利于老年出租车司机发生急性血管事件。考虑的预防措施包括对抗凝食物和水摄入的社会支持、短时间锻炼和步行,以及在夜间工作期间休息和小睡。

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