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[昼夜节律类型作为女性轮班工作耐受性的一个因素]

[Chrono-type as a factor of shiftwork tolerance in women].

作者信息

Ogińska H, Pokorski J, Ogiński A

机构信息

Zakładu Ergonomii Katedry Medycyny Pracy i Chorób Zawodowych, Akademii Medycznej im. M. Kopernika, Krakowie.

出版信息

Folia Med Cracov. 1990;31(4):225-42.

PMID:2135892
Abstract

Almost all physiological and psychological functions of human beings reveal circadian variations. The parameters of those rhythms differ in various subjects dependently on their individual diurnal characteristics, named here chrono-type. The difference in phase of maximal arousal is particularly apparent so that it implies the distinction between the morning and the evening types. The comparative study of both chrono-types was done with regard to the subjective health, sleep disorders and disturbances, attitudes towards shiftwork and physical fitness as measured by indirect prediction of the maximal oxygen uptake. In spite of differences in the bedtime and awaking time, representatives of morning and evening type did not differ when considering the amount of sleep. Both groups slept about one hour less than subjectively required. The analysis of sleep disorders (during days with various shifts and days off) showed that their configuration was different in compared groups. Morning types more often woke before proper time and suffered from frequent mid-sleep awakenings. They had also more difficulties in falling asleep and felt tired after awakening when working night shift. Evening types reported more often difficulties in awakening (independently on work shift) and complained low well-being or tiredness after awakening when working morning or afternoon shift and during days off. The percentage of morning types reporting various sleep disturbances of external (noise, daylight) or internal (hunger, nervousness) origin was 13 to 74. The corresponding figures for evening types were 4 to 52%. Subjective health was assessed with use of a list of 74 symptoms. It was found that morning individuals significantly more frequently reported fevers and sub-febrile states, itching in heart region, pains or tightness in heart region when nervous and musculoskeletal pains. No significant differences in gastrointestinal complaints were found. Analysis of typical circulatory, respiratory and musculoskeletal syndromes revealed the lower frequency of circulatory and musculoskeletal complaints and more respiratory symptoms in evening types. This latter could be considered as the result of prevalence of smokers in this group. The prediction of maximal oxygen uptake with use of indirect Astrand-Rhythm method showed significantly higher values in evening types. Taking into account that the result of this method is based on the heart rate response to submaximal load--it is highly probable that the difference observed is due to chrono-type related difference in phase of circadian rhythm of heart rate reaction to the load applied on the same time of the day. Both studied groups differed significantly as to the percentage of persons approving the work in shifts.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

几乎人类所有的生理和心理功能都呈现出昼夜节律变化。这些节律的参数在不同个体中存在差异,这取决于他们各自的昼夜特征,在此称为时辰类型。最大觉醒相位的差异尤为明显,这意味着早晨型和夜晚型之间的区别。针对主观健康状况、睡眠障碍与干扰、对轮班工作的态度以及通过间接预测最大摄氧量来衡量的身体素质,对这两种时辰类型进行了比较研究。尽管就寝时间和起床时间存在差异,但在考虑睡眠时间时,早晨型和夜晚型的代表并无不同。两组的睡眠时间都比主观需求少约一小时。对睡眠障碍(在不同轮班日和休息日)的分析表明,在比较的两组中其构成有所不同。早晨型的人更常过早醒来,且频繁在睡眠中醒来。他们在值夜班时入睡也更困难,醒来后会感到疲倦。夜晚型的人更常报告醒来困难(与工作轮班无关),并抱怨在值早班或下午班以及休息日醒来后身体不适或疲倦。报告有各种外部(噪音、 daylight)或内部(饥饿、紧张)原因导致的睡眠障碍的早晨型人的比例为13%至74%。夜晚型的相应数字为4%至52%。使用包含74种症状的列表对主观健康状况进行评估。结果发现,早晨型的人显著更频繁地报告发烧和低热状态、心脏区域瘙痒、紧张时心脏区域疼痛或紧绷以及肌肉骨骼疼痛。在胃肠道不适方面未发现显著差异。对典型的循环、呼吸和肌肉骨骼综合征的分析显示,夜晚型中循环和肌肉骨骼不适的发生率较低,而呼吸系统症状较多。后者可被视为该组中吸烟者占比高的结果。使用间接的阿斯特兰德-节律法预测最大摄氧量显示,夜晚型的值显著更高。考虑到该方法的结果基于心率对次最大负荷的反应,很可能观察到的差异是由于在一天中同一时间施加负荷时,时辰类型与心率反应昼夜节律相位的相关差异所致。在赞成轮班工作的人员比例方面,两个研究组存在显著差异。

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