Sorokin A V, Prazdnov A S, Korovina O V
Klin Med (Mosk). 2007;85(11):39-42.
The authors studied correlations between occupational stress, caused by high tension at work, and disturbances in 24-hour arterial pressure (AP), lipid level, and left ventricular (LM) myocardial remodeling in locomotive engineers with normal AP. Two hundred and five locomotive engineers with NAP (according to 2004 classification by Russian Scientific Society of Cardiologists) aged 20 to 45 years were included in this cross-sectional study; the subjects present a whole sample of the locomotive crew of Chelyabinsk railway station. The control group consisted of III persons working eight fixed working hours a day whose work was not associated with high tension (turners and metalworkers). The examination of the both groups included bifunctional 24-hour AP and ECG monitoring during the subjects'days off, Echo CG, measurement of blood lipids, and measurement of table salt sensitivity threshold. Also evaluated were the prevalence of horizontal and vertical family background of arterial hypertension, excessive body weight, hypokinesia, and smoking. The study demonstrated that the prevalence of the chief factors of chronic non-infectious diseases as well as the values of office and 24-hour systolic and diastolic arterial pressure (SAD; DAD) were the same in both groups. At the same time, the locomotive engineers with normal AP had unfavorable hemodynamic AP profile (24-hour SAD index (p = 0.008) was lower indicating insufficient SAD decrease at night; the speed of morning SAD and DAD increase was elevated 1.5 to 2 times; heart rate was higher as well) which can be considered signs of hypersympathicotonia. By comparison with the controls, the locomotive engineers had more pronounced morphofunctional changes in the left ventricular (LV), myocardium; LV mass was greater, and LV myocardial hypertrophy was more frequent in this group (17.9 and 1.8%, respectively). The data demonstrate the contribution of occupational stress-related non-hemodynamic factors to myocardial remodeling and atherogenic lipid shift in individuals whose occupational activity is connected with high tension.
作者研究了工作高度紧张所致职业压力与正常动脉血压（AP）的机车工程师24小时动脉血压紊乱、血脂水平及左心室（LM）心肌重构之间的相关性。本横断面研究纳入了205名年龄在20至45岁之间、动脉血压正常（根据俄罗斯心脏病学家科学协会2004年分类标准）的机车工程师；这些受试者构成了车里雅宾斯克火车站机车乘务员的完整样本。对照组由30名每天固定工作8小时且工作与高度紧张无关的人员组成（车工和金属工人）。两组受试者均在休息日接受了双功能24小时动脉血压和心电图监测、超声心动图检查、血脂测量以及食盐敏感性阈值测量。还评估了动脉高血压的水平和垂直家族背景、超重、运动不足和吸烟的患病率。研究表明，两组慢性非传染性疾病主要因素的患病率以及诊室血压和24小时收缩压及舒张压（SAD；DAD）值相同。与此同时，动脉血压正常的机车工程师具有不利的血液动力学动脉血压特征（24小时SAD指数较低（p = 0.008），表明夜间SAD下降不足；早晨SAD和DAD升高速度提高了1.5至2倍；心率也较高），这可被视为高交感神经张力的迹象。与对照组相比，机车工程师左心室（LV）心肌的形态功能变化更为明显；该组LV质量更大，LV心肌肥厚更为常见（分别为17.9%和1.8%）。数据表明，职业活动与高度紧张相关的个体中，职业压力相关的非血液动力学因素对心肌重构和致动脉粥样硬化性脂质变化有影响。
