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女性护士昼夜节律紊乱与静息态下丘脑功能性连接的 相关性研究
吴晓莉  白帆  王云雷  刘丽旭  陈予东  厉含之  张璐  张通  
0
()
摘要:
目的 探索长期夜班轮班的年轻女性护士发生昼夜节律紊乱以及脑功能连接(FC)改变 情况并分析两者之间的相关性。方法 采用前瞻性对照设计,共纳入 9 名女性夜班护士和 9 名年龄匹 配的女性白班护士为研究对象,完成匹兹堡睡眠质量指数(PSQI)和 Epworth 嗜睡量表(ESS)调查。采集 24 h 内 5 个时间点(2:00、6:00、10:00、16:00 和 22:00)的血清褪黑素和皮质醇水平,并行全脑静息态 fMRI 扫描,将下丘脑作为种子区进行脑 FC 分析。采用 Spearman 相关分析两组护士脑 FC 与血清皮质醇、 褪黑素水平的相关性,以及年龄、PSQI 评分、ESS 评分与护士夜班工作年限之间的相关性。结果 夜 班护士的 PSQI 和 ESS 评分高于白班护士[(8.44±3.90)分 vs(3.11±1.90)分、8.0(6.0,11.0)分 vs 5.0(2.0, 2.5)分],差异有统计学意义(P< 0.01)。夜班护士血清褪黑素水平低于白班护士[(135.18±20.84)pg/ml vs(185.83±25.97)pg/ml],差异有统计学意义(F=69.653,P< 0.01),且节律曲线紊乱。夜班护士血清 皮质醇水平高于白班护士[(7.64±0.60)nmol/L vs(6.84±0.75)nmol/L],差异有统计学意义(F=211.081, P< 0.01)。夜班护士下丘脑至右侧扣带回、右侧壳核和小脑蚓部间的脑 FC 强于白班护士,差异有统 计学意义(P< 0.05);且夜班护士下丘脑至小脑蚓部的 FC 增强与 ESS 评分呈正相关(r=0.501,P=0.034)。 结论 护士长期值夜班轮班可出现睡眠质量下降、夜间褪黑素水平下降及皮质醇节律紊乱,同时伴有 静息态脑 FC 改变。
关键词:  护士  夜班  褪黑素  昼夜节律  静息态核磁共振扫描  功能连接
DOI:10.3969/j.issn.1009-6574.2022.06.010
基金项目:中央级公益性科研院所基本科研业务费专项基金项目(2017CZ-3、2020CZ-7)
Correlation between circadian rhythm disorder and resting hypothalamic functional connection in female nurses
Wu Xiaoli,Bai Fa,Wang Yunlei,Liu Lixu,Chen Yudong,Li Hanzhi,Zhang Lu,Zhang Tong
()
Abstract:
Objective To explore the circadian rhythm disorder and brain functional connectivity (FC) changes of young female nurses on long-term night shift, and analyze the correlation between them. Methods A prospective case control design was adopted, a total of 9 female nurses on night shift duty and 9 age-matched female nurses on day shift were included as the research objects. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were completed. The levels of serum melatonin and cortisol were collected at 5 time points (2:00, 6:00, 10:00, 16:00 and 22:00) within 24 hours, and the whole brain was scanned with resting fMRI. The hypothalamus was used as the seed area for brain FC analysis. Spearman correlation analysis was used to analyze the correlation between brain FC and serum cortisol and melatonin levels of nurses in the two groups, as well as the correlation between age, PSQI score, ESS score and working years of nurses on night shift. Results The PSQI and ESS scores of the night shift nurse were higher than those of the day shift nurse [(8.44±3.90) vs (3.11±1.9); 8.0(6.0, 11.0) vs 5.0(2.0, 2.5)], and the differences were statistically significant (P< 0.01). The serum melatonin level of the night shift nurse was lower than that of the day shift nurse [(135.18±20.84) pg/ml vs (185.83±25.97) pg/ml], the difference was statistically significant (F=69.653,P < 0.01), and the rhythm curve was disordered. The serum cortisol level of the night shift nurse was higher than that of the day shift nurse [(7.64±0.60) nmol/L vs (6.84±0.75) nmol/L], and the difference was statistically significant (F=211.081, P< 0.01). The brain FC from hypothalamus to right cingulate gyrus, right putamen and cerebellar vermis of the night shift nurse was stronger than that of the day shift nurse, the difference was statistically significant (P< 0.05). The FC enhancement from hypothalamus to cerebellar vermis of the night shift nurses was positively correlated with ESS score (r=0.501, P=0.034). Conclusions Nurses on long-term night shift may have decreased sleep quality, decreased melatonin level at night and cortisol rhythm disorder, accompanied by resting brain FC changes.
Key words:  Nurse  Night shift  Melatonin  Circadian rhythm  Resting state functional magnetic resonance imaging  Functional connectivity

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