摘要
目的 分析煤矿工人高血压的患病现况及影响因素,探究煤矿工人高血压与慢性心理应激之间的关联性及其阈值效应和饱和效应,为煤矿工人高血压防治提供流行病学参考依据。方法 基于课题组2022年2月—2022年10月在河南、山西和河北地区建立的煤矿工人队列基线资料,以9 866名煤矿工人作为研究对象,采用横断面研究,通过调查问卷来收集个人一般情况、职业史、健康状况、生活习惯以及慢性心理应激等资料。同时收集了研究对象的人体测量学指标以及血糖、血脂、血压、高密度脂蛋白等血液生化指标。分析煤矿工人高血压患病现状及其影响因素。以慢性心理应激为主要研究因素,以是否患有高血压为结局事件,采用非条件二分类logistic回归方法分析慢性心理应激(重大生活事件、一般压力、经济压力、焦虑抑郁状态)与高血压的关联性,计算综合社会心理应激指数,运用非条件二分类logistic回归结合限制性立方样条模型(RCS)分析综合社会心理应激指数与高血压之间的关联性及阈值效应和饱和效应。结果 煤矿工人高血压患病率为21.3%。多因素分析结果提示,人口学特征、基础疾病、行为习惯、睡眠习惯、职业行为、经济压力是煤矿工人高血压患病的影响因素(P<0.05)。校正可能的混杂因素后,综合社会心理应激指数和煤矿工人高血压之间为线性剂量反应关系。调整了可能的混杂因素后,以综合社会心理应激指数在5.47~6.84为参照组,煤矿工人的综合社会心理应激指数在6.84~8.21、8.21~9.57和≥9.57时,其患高血压的比值比(OR)分别是1.138[95%置信区间(CI):1.031~1.359]、1.173(95%CI:1.241~1.577)和1.249(95%CI:1.110~1.623)。结论 煤矿工人高血压整体患病率为21.3%,人口学特征(年龄、婚姻状态、家庭月收入、教育水平、脉率、BMI)、基础疾病(咽喉炎、腰背痛、心脏病、高血脂、痛风、慢性肾病)、行为习惯(饮酒、午睡)、睡眠习惯(匹兹堡睡眠指数)、职业行为(连续倒班)是煤矿工人高血压的患病的可能影响因素。校正可能的混杂因素后经济压力与煤矿工人患高血压具有关联性,综合社会心理应激指数与高血压存在线性关系。
Objective To clarify the prevalence and influencing factors of hypertension in coal mine workers,explore the correlation between hypertension and chronic psychological stress,its threshold effect and saturation effect,and provide epidemiological reference for the prevention and treatment of hypertension in coal mine workers.Methods Based on the baseline data of coal mine workers in Henan,Shanxi and Hebei from February 2022 to October 2022,9866 coal mine workers were selected as subjects in a cross-sectional study and questionnaires were used to collect personal data such as general situation,occupational history,health status,living habits and chronic psychological stress.At the same time,the anthropometric indexes,blood glucose,blood lipid,blood pressure,high density lipoprotein cholesterol and other blood biochemical indexes were collected.With chronic psychological stress as the main factor and hypertension as the outcome event,the correlation between chronic psychological stress(major life events,general stress,economic stress,anxiety and depression)and hypertension was analyzed by unconditioned binary Logistic regression method.Partial regression coefficients related to each part of chronic psychological stress in the regression model were used to calculate the comprehensive psychosocial stress index,and unconditional binary Logistic regression combined with Restricted cubic spline model was applied.RCS was used to analyze the correlation between comprehensive psychosocial stress index and hypertension and whether there was threshold effect and saturation effect between them.Results The prevalence of hypertension among coal miners was 21.3%.Multivariate analysis results indicate that demographic characteristics,comorbidities,behavioral habits,sleep habits,occupational behavior,and economic pressure are factors influencing hypertension among coal miners(P<0.05).After adjusting for possible confounding factors,there is a linear dose-response relationship between the comprehensive social psychological stress index and hypertension among coal miners.3.After adjusting for possible confounding factors,the OR for hypertension among coal miners with comprehensive social psychological stress indices in the ranges of 6.84-8.21,8.21-9.57,and≥9.57,compared to the reference group of 5.47-6.84,were 1.138[95%CI:1.031-1.359],1.173(95%CI:1.241-1.577),and 1.249(95%CI:1.110-1.623),respectively.Conclusion The overall prevalence rate of hypertension in coal miners is 21.3%.Through univariate analysis and multivariate analysis,demographic characteristics,underlying diseases,behavior habits,sleep habits and occupational behaviors are the possible influencing factors of hypertension in coal miners.After adjusting for possible confounders,economic stress is correlated with hypertension of coal miners.The chronic psychological stress of individuals can be fully reflected by calculating each dimension into the comprehensive psychosocial stress index,and the comprehensive psychosocial stress index has a linear relationship with hypertension.
作者
李海斌
李鑫潇
王永斌
姚三巧
LI Haibin;LI Xinxiao;WANG Yongbin;YAO Sanqiao(School of Public Health,North China University of Science and Technology,Tangshan 063210,China)
出处
《中国煤炭工业医学杂志》
2024年第5期515-525,共11页
Chinese Journal of Coal Industry Medicine
基金
河南省自然科学基金(编号:222300420265)
河南省高等教育教学改革研究与实践项目(研究生教育类)(编号:2023SJGLX061Y、2023SJGLX010Y)
关键词
高血压
煤矿工人
横断面研究
慢性心理应激
限制性立方样条
Hypertension
Coal miners
Cross-sectional study
Chronic psychological stress
Restricted cubic splines
