罗科学　王钦贤　陈富兴

[摘要] 目的 调查长期夜班工作医务人员肠道菌群结构的变化，探讨肠道菌群与长期夜班工作所致慢性疾病的关系。方法 采集30例有5年以上夜班工作经历的医务人员（试验组）及30例非夜班工作的健康志愿者（健康对照组）的粪便，利用荧光定量PCR方法定量分析两组人群肠道主要菌群结构的变化。 结果 试验组与健康对照组相比，长期夜班工作的医护人员的拟杆菌、双歧杆菌、乳酸杆菌含量均有下降，差异有高度统计学意义（P<0.01）。而肠球菌和肠杆菌则较健康对照组有所升高，其中肠球菌组间比较，差异有高度统计学意义（P<0.01），肠杆菌组间比较，差异有统计学意义（P<0.05）。 结论 长期夜班工作医务人员肠道内益生菌拟杆菌、双歧杆菌、乳酸杆菌减少，条件致病菌肠球菌和肠杆菌增多，存在较明显的肠道菌群结构失调。

[关键词] 长期夜班工作医务人员；肠道菌群；荧光定量PCR；调查

[中图分类号] R378 [文献标识码] B [文章编号] 1673-9701（2017）28-0126-04

[Abstract] Objective To investigate the changes of intestinal flora structure in medical staff taking long-term night shift， and to explore the relationship between intestinal flora and chronic diseases caused by long-term night work. Methods Faeces of 30 cases of medical personnel with more than 5 years working experience of night work（experimental group） and 30 healthy volunteers who had no night work（healthy control group） were collected. Fluorescence quantitative PCR method was used to quantitatively analyze the changes of main intestinal flora structure in the two groups. Results Compared with the healthy control group， the contents of Bacteroides， Bifidobacterium and Lactobacillus in the medical staff taking long-term night shift were all decreased in the experimental group. There were statistically significant differences between the two groups（P<0.01）. The contents of Enterococcus and Enterobacteriaceae were higher than those in the healthy control group， and there was significant difference in Enterococcus between two groups（P<0.01）. The difference in Enterobacteriaceae was significant between two groups（P<0.05）. Conclusion The contents of intestinal probiotics such as Bacteroides， Bifidobacterium and Lactobacillus are decreased in the medical staff taking long-term night shift， while the conditioned pathogens such as Enterococcus and Enterobacteria are increased. There are more significant intestinal flora structural disorders.

[Key words] Medical staff taking long-term night shift； Intestinal microflora； Fluorescence quantitative PCR； Investigation

医务工作者工作繁忙，工作节奏快，职业压力大，会影响到本身的心身健康。尤其是长期夜班工作的医护人员，长期的睡眠-觉醒周期不规律，缺乏运动，饮食不规律，以及经常面对夜班突发应激事件，不但会引起职业倦怠，导致亚健康状态，使医疗工作效率下降，甚至会出现医疗差错。而且也会导致疲劳综合征、肥胖、高血压、慢性胃炎、抑郁症等疾病[1]。

肠道菌群参与人体的消化、营养物质的吸收、能量的供应、脂肪代谢、免疫调节等诸多环节，不管是在健康状态还是在疾病状态下的人体代谢过程均会受肠道菌群的影响[2-3]。长期夜班工作有可能会导致肠道菌群的变化，而这种变化可能是导致亚健康状态和相关慢性疾病产生的关键因素。因此，研究夜班工作医务人员肠道菌群的变化，不但对相关慢性疾病有预防意义，同时可以进一步针对肠道菌群为靶点进行治疗。……