JACC：轮班工作打乱昼夜节律可加重心肌梗死的再灌注损伤

2022-05-30 MedSci原创 MedSci原创

轮班工作增加心肌梗死再灌注损伤

经济需求和向普通人群延伸的基础服务需要持续的人力劳动，导致20%-30%的劳动力从事轮班工作（如护士，上夜班）。轮班工作导致的生物节律紊乱与慢性疾病的风险增加及预后较差有关，包括急性心肌梗死（AMI）、癌症和代谢功能障碍。但是，轮班工作与AMI预后恶化的机制尚不明确。

本研究旨在探索轮班工作对再灌注损伤（AMI临床预后的主要决定因素）的影响。

这是一项前瞻性、多中心的关于ST段抬高型心肌梗死患者在再灌注治疗后接受心脏磁共振成像的研究，研究人员从EARLY-MYO-CMR数据库获得患者数据。主要终点是CMR定义的再灌注后梗死面积。次要临床终点是随访期间主要不良心脏事件 (MACE) 的综合情况。同时，通过临床前动物模型探索潜在机制。

有无轮班工作的患者的心肌梗死面积

在EARLY-MYO-CMR研究找按摩了706位患者中，412位STEMI患者被纳入分析。轮班工作与CMR定义的心肌梗死面积增大相关（β：5.94%; 95% CI 2.94-8.94; P<0.0001）。在中位随访5.0年内，轮班工作与MACE风险增加相关（校正HR 1.92, 95% CI 1.12-3.29，P=0.017）。

有无轮班工作对STEMI患者长期预后的影响

与临床发现相一致，在小鼠和绵羊中，轮班工作模拟可明显增加AMI动物的再灌注损伤。机制研究显示，一个新的核受体亚家族1组D成员1/心脏滋养素样细胞因子1轴在介导轮班工作对心肌损伤的有害影响中发挥了关键作用。

有无轮班工作小鼠模型的累积死亡率

简而言之，本研究提供了轮班工作增加心肌梗死再灌注损伤的新证据，并发现了一个新的核受体亚家族1组D成员1/心脏滋养素样细胞因子1轴，可能在该过程中发挥关键作用。

原始出处：

Zhao Yichao,Lu Xiyuan,Wan Fang et al. Disruption of Circadian Rhythms by Shift Work Exacerbates Reperfusion Injury in Myocardial Infarction.[J] .J Am Coll Cardiol, 2022, 79: 2097-2115. https://doi.org/10.1016/j.jacc.2022.03.370.

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2023-02-21 ms9833124466084992

#再灌注损伤#

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2022-08-16 hbwxf

#JACC#

58 0
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2022-10-01 lifestar

#轮班工作#导致的#生物节律#紊乱与#慢性疾病#的风险增加及预后较差有关，包括急性#心肌梗死#（AMI）、#癌症#和#代谢#功能障碍。轮班工作增加心肌梗死#再灌注损伤#的新证据。#夜班#多也是这个道理。#昼夜节律##生物钟#

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2022-12-10 chenhongpeng

#轮班工作#

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2022-06-02 王严玮

研究层出不穷，轮班的危害非常确切，但是始终叫不醒装睡的人

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2022, time=2022-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1951162, encodeId=947b1951162cd, content=<a href='/topic/show?id=07559349652' target=_blank style='color:#2F92EE;'>#轮班工作#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93496, encryptionId=07559349652, topicName=轮班工作)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Sat Dec 10 17:01:12 CST 2022, time=2022-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224057, encodeId=9518122405e71, content=研究层出不穷，轮班的危害非常确切，但是始终叫不醒装睡的人, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9611710563, createdName=王严玮, createdTime=Thu Jun 02 15:12:41 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326954, encodeId=981e1326954f0, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue May 31 12:01:12 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398343, encodeId=26d6139834371, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 31 12:01:12 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1223394, encodeId=532312233942c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Mon May 30 17:47:34 CST 2022, time=2022-05-30, status=1, ipAttribution=)]
2022-05-31 仁医06

#ACC#

44 0
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createdBy=55ce62, createdName=hbwxf, createdTime=Tue Aug 16 07:01:12 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2091326, encodeId=c62c20913266e, content=<a href='/topic/show?id=07559349652' target=_blank style='color:#2F92EE;'>#轮班工作#</a>导致的<a href='/topic/show?id=15e669446ef' target=_blank style='color:#2F92EE;'>#生物节律#</a>紊乱与<a href='/topic/show?id=5fe4535e836' target=_blank style='color:#2F92EE;'>#慢性疾病#</a>的风险增加及预后较差有关，包括急性<a href='/topic/show?id=b086512e33c' target=_blank style='color:#2F92EE;'>#心肌梗死#</a>（AMI）、<a href='/topic/show?id=d8dbe130197' target=_blank style='color:#2F92EE;'>#癌症#</a>和<a href='/topic/show?id=91eb2540054' target=_blank style='color:#2F92EE;'>#代谢#</a>功能障碍。轮班工作增加心肌梗死<a href='/topic/show?id=8c323064e09' target=_blank style='color:#2F92EE;'>#再灌注损伤#</a>的新证据。<a href='/topic/show?id=4ab143518a3' target=_blank style='color:#2F92EE;'>#夜班#</a>多也是这个道理。<a href='/topic/show?id=c19159e1570' target=_blank style='color:#2F92EE;'>#昼夜节律#</a><a href='/topic/show?id=6a3c69486e3' target=_blank style='color:#2F92EE;'>#生物钟#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93496, encryptionId=07559349652, topicName=轮班工作), TopicDto(id=69446, encryptionId=15e669446ef, topicName=生物节律), TopicDto(id=53578, encryptionId=5fe4535e836, topicName=慢性疾病), TopicDto(id=51273, encryptionId=b086512e33c, topicName=心肌梗死), TopicDto(id=71301, encryptionId=d8dbe130197, topicName=癌症), TopicDto(id=25400, encryptionId=91eb2540054, topicName=代谢), TopicDto(id=30647, encryptionId=8c323064e09, topicName=再灌注损伤), TopicDto(id=43518, encryptionId=4ab143518a3, topicName=夜班), TopicDto(id=59715, encryptionId=c19159e1570, topicName=昼夜节律), TopicDto(id=69486, encryptionId=6a3c69486e3, topicName=生物钟)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Sat Oct 01 12:17:14 CST 2022, time=2022-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1951162, encodeId=947b1951162cd, content=<a href='/topic/show?id=07559349652' target=_blank style='color:#2F92EE;'>#轮班工作#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93496, encryptionId=07559349652, topicName=轮班工作)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Sat Dec 10 17:01:12 CST 2022, time=2022-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224057, encodeId=9518122405e71, content=研究层出不穷，轮班的危害非常确切，但是始终叫不醒装睡的人, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9611710563, createdName=王严玮, createdTime=Thu Jun 02 15:12:41 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326954, encodeId=981e1326954f0, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue May 31 12:01:12 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398343, encodeId=26d6139834371, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 31 12:01:12 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1223394, encodeId=532312233942c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Mon May 30 17:47:34 CST 2022, time=2022-05-30, status=1, ipAttribution=)]
2022-05-31 ms3046638856685384

#损伤#

38 0
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createdBy=55ce62, createdName=hbwxf, createdTime=Tue Aug 16 07:01:12 CST 2022, time=2022-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2091326, encodeId=c62c20913266e, content=<a href='/topic/show?id=07559349652' target=_blank style='color:#2F92EE;'>#轮班工作#</a>导致的<a href='/topic/show?id=15e669446ef' target=_blank style='color:#2F92EE;'>#生物节律#</a>紊乱与<a href='/topic/show?id=5fe4535e836' target=_blank style='color:#2F92EE;'>#慢性疾病#</a>的风险增加及预后较差有关，包括急性<a href='/topic/show?id=b086512e33c' target=_blank style='color:#2F92EE;'>#心肌梗死#</a>（AMI）、<a href='/topic/show?id=d8dbe130197' target=_blank style='color:#2F92EE;'>#癌症#</a>和<a href='/topic/show?id=91eb2540054' target=_blank style='color:#2F92EE;'>#代谢#</a>功能障碍。轮班工作增加心肌梗死<a href='/topic/show?id=8c323064e09' target=_blank style='color:#2F92EE;'>#再灌注损伤#</a>的新证据。<a href='/topic/show?id=4ab143518a3' target=_blank style='color:#2F92EE;'>#夜班#</a>多也是这个道理。<a href='/topic/show?id=c19159e1570' target=_blank style='color:#2F92EE;'>#昼夜节律#</a><a href='/topic/show?id=6a3c69486e3' target=_blank style='color:#2F92EE;'>#生物钟#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93496, encryptionId=07559349652, topicName=轮班工作), TopicDto(id=69446, encryptionId=15e669446ef, topicName=生物节律), TopicDto(id=53578, encryptionId=5fe4535e836, topicName=慢性疾病), TopicDto(id=51273, encryptionId=b086512e33c, topicName=心肌梗死), TopicDto(id=71301, encryptionId=d8dbe130197, topicName=癌症), TopicDto(id=25400, encryptionId=91eb2540054, topicName=代谢), TopicDto(id=30647, encryptionId=8c323064e09, topicName=再灌注损伤), TopicDto(id=43518, encryptionId=4ab143518a3, topicName=夜班), TopicDto(id=59715, encryptionId=c19159e1570, topicName=昼夜节律), TopicDto(id=69486, encryptionId=6a3c69486e3, topicName=生物钟)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Sat Oct 01 12:17:14 CST 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time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326954, encodeId=981e1326954f0, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Tue May 31 12:01:12 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398343, encodeId=26d6139834371, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 31 12:01:12 CST 2022, time=2022-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1223394, encodeId=532312233942c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Mon May 30 17:47:34 CST 2022, time=2022-05-30, status=1, ipAttribution=)]
2022-05-30 ms6000001791212108

学习了

52 0

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