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实验性短期晚班和夜班对人体昼夜节律的急性影响:口腔温度、心率、血清皮质醇和尿儿茶酚胺水平。

The acute effects of experimental short-term evening and night shifts on human circadian rhythm: the oral temperature, heart rate, serum cortisol and urinary catecholamines levels.

作者信息

Fujiwara S, Shinkai S, Kurokawa Y, Watanabe T

机构信息

Department of Hygiene, Ehime University School of Medicine, Japan.

出版信息

Int Arch Occup Environ Health. 1992;63(6):409-18. doi: 10.1007/BF00386937.

Abstract

This study was designed to examine the temporal changes in circadian rhythm of oral temperature, heart rate, serum cortisol and urinary catecholamines levels due to experimental short-term shifts. The six subjects were assigned to consecutive day (work 0800-1600 hours; sleep 0000-0800 hours), evening (1600-2400 hours; 0400-1200 hours), and night (0000-0800 hours; 1200-2000 hours) shifts of 2 days each scheduled as hospital shiftwork by nurses, in random order, during which data were collected every 4 h throughout the experimental periods. According to acrophases of a fitted cosine curve and visual inspection on chronograms, the phases of circadian rhythms were delayed to different degrees in the evening shifts with a minimum of about 1 h for oral temperature and a maximum of about 4 h for urinary free noradrenaline. The corresponding phase delays were larger in the night shift for oral temperature (about 3 h), resting heart rate (about 5 h) and urinary free noradrenaline (about 13 h); the diurnal variations of serum cortisol and urinary free adrenaline were greatly modified, and their circadian rhythmicities disappeared, indicating that the normal circadian phase relations of these variables were disrupted more by the night shift. The comparison of chronograms and correlation analyses revealed that the 4-h mean heart rate and urinary free noradrenaline were largely affected by rest-activity level in connection with shifts, while the resting heart rate and urinary free adrenaline were less affected. On the other hand, the sleep factor (time of onset and/or period) seemed to be more potent in modifying the circadian rhythm of serum cortisol, especially with the night shifts.

摘要

本研究旨在探讨由于实验性短期轮班导致的口腔温度、心率、血清皮质醇和尿儿茶酚胺水平昼夜节律的时间变化。六名受试者被随机安排按照护士排班的医院轮班模式,依次进行为期2天的日班(工作时间08:00 - 16:00;睡眠时间00:00 - 08:00)、中班(16:00 - 24:00;04:00 - 12:00)和夜班(00:00 - 08:00;12:00 - 20:00)轮班,在此期间,在整个实验阶段每4小时收集一次数据。根据拟合余弦曲线的峰相位和对时间图的目视检查,中班时昼夜节律的相位不同程度地延迟,口腔温度最少延迟约1小时,尿游离去甲肾上腺素最多延迟约4小时。夜班时,口腔温度(约3小时)、静息心率(约5小时)和尿游离去甲肾上腺素(约13小时)的相应相位延迟更大;血清皮质醇和尿游离肾上腺素的昼夜变化被极大改变,其昼夜节律消失,表明这些变量的正常昼夜相位关系在夜班时受到的破坏更大。时间图比较和相关性分析显示,4小时平均心率和尿游离去甲肾上腺素在很大程度上受与轮班相关的休息 - 活动水平影响,而静息心率和尿游离肾上腺素受影响较小。另一方面,睡眠因素(入睡时间和/或时长)似乎在改变血清皮质醇的昼夜节律方面作用更强,尤其是在夜班时。

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