Ishizaki M, Tsuritani I, Noborisaka Y, Yamada Y, Tabata M, Nakagawa H
Department of Hygiene, Kanazawa Medical University, Ishikawa, Japan.
Int Arch Occup Environ Health. 1996;68(5):315-20. doi: 10.1007/BF00409416.
Psychosocial job stress has been shown to be associated with the development of cardiovascular disease. However, the pathophysiological mechanisms underlying this relationship remain unclear. The aim of the present study was to elucidate whether marked job stress affects the parameters of blood coagulation and fibrinolysis, such as plasma fibrinogen concentration, tissue plasminogen activator (t-PA), and plasminogen activator inhibitor 1 (PAI-1) activities, in 213 middleaged male workers in a computer-producing factory. Job stress was measured using a Japanese version of the Job Content Questionnaire (JCQ) developed by Karasek. The mean t-PA activity in workers with lower and higher job demands was 0.23 and 0.18 IU/ml respectively, and this difference was significant (P < 0.05). The mean plasma fibrinogen in workers with lower and higher job decision latitude was 224.8 and 236.3 mg/dl respectively, and the mean PAI-1 activity in workers with lower and higher job strain was 14.9 and 17.7 U/ml respectively, though these differences remained at a borderline level of significance (0.05 < P < 0.10). Multiple regression analyses showed that the parameters of blood coagulation and fibrinolysis were closely associated with the cardiovascular risk factors of age, obesity, blood pressure, elevated serum lipids, and smoking, but that high job demands were significantly related to decreases in t-PA activity, independently of the traditional risk factors. These results suggest that psychosocial job stress may be related, at least partly, to the development of cardiovascular disease via changes in plasma fibrinolytic activity.
心理社会工作压力已被证明与心血管疾病的发生有关。然而,这种关系背后的病理生理机制仍不清楚。本研究的目的是阐明在一家计算机生产厂的213名中年男性工人中,显著的工作压力是否会影响凝血和纤维蛋白溶解参数,如血浆纤维蛋白原浓度、组织纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制剂1(PAI-1)活性。使用Karasek开发的日语版工作内容问卷(JCQ)来测量工作压力。工作要求较低和较高的工人的平均t-PA活性分别为0.23和0.18 IU/ml,这种差异具有统计学意义(P < 0.05)。工作决策自由度较低和较高的工人的平均血浆纤维蛋白原分别为224.8和236.3 mg/dl,工作紧张程度较低和较高的工人的平均PAI-1活性分别为14.9和17.7 U/ml,尽管这些差异仍处于临界显著水平(0.05 < P < 0.10)。多元回归分析表明,凝血和纤维蛋白溶解参数与年龄、肥胖、血压、血脂升高和吸烟等心血管危险因素密切相关,但高工作要求与t-PA活性降低显著相关,且独立于传统危险因素。这些结果表明,心理社会工作压力可能至少部分地通过血浆纤溶活性的变化与心血管疾病的发生有关。