School of Health Sciences, Nursing, Kobe Tokiwa University, Japan.
Department of Nursing, Kobe University Hospital, Japan.
Ind Health. 2024 Sep 27;62(5):324-333. doi: 10.2486/indhealth.2023-0157. Epub 2024 May 14.
The influence of night shift work on circadian heart-rate rhythm was examined in nurses engaged in shift work using a Holter electrocardiogram, continuously measured for two weeks, and cosine periodic regression analysis. We enrolled 11 nurses who were engaged in a two-shift system. The R value in the cosine regression curve of heart-rate rhythm (concordance rate), indicating the concordance rate between the actual heart rate over 24 h and the cosine regression curve approximated by the least-squares procedure, was significantly lower in the night shift (0.40 ± 0.15) than in the day shift (0.66 ± 0.19; p<0.001). Moreover, the amplitude was significantly lower and the acrophase was significantly delayed in the night shift. Thus, the circadian heart-rate rhythm was disrupted by the night shift work. Although the heart-rate acrophase recovered during the day and two days after the night shift, the concordance rate and amplitude did not recover, indicating that the influence of night shift work on circadian heart-rate rhythm might persist even two days after the night shift. Based on these results, adequate clinical attention should be paid to how to spend the day and two days after the night shift to correct the circadian heart-rate rhythm disruption caused by night shift work.
我们使用动态心电图仪，连续监测两周，采用余弦回归分析的方法，研究了倒班护士夜间工作对昼夜心率节律的影响。我们招募了 11 名从事两班制的护士。余弦回归曲线心率节律的 R 值（一致性率），表示 24 小时实际心率与最小二乘法近似的余弦回归曲线之间的一致性率，夜间（0.40±0.15）显著低于日间（0.66±0.19；p<0.001）。此外，夜间的振幅显著降低，高峰时间明显延迟。因此，昼夜心率节律被夜间工作打乱了。尽管夜间工作后的白天和两天内，心率高峰时间有所恢复，但一致性率和振幅并未恢复，这表明即使在夜间工作后的两天，夜间工作对昼夜心率节律的影响仍可能持续。基于这些结果，应充分关注如何度过夜班后的白天和两天，以纠正夜班工作引起的昼夜心率节律紊乱。
