闫盼　　王萍　　李静　　王晟东　王姝琪　　方悦　　宋明芬

1.杭州市第七人民醫院  浙江大学医学院附属精神卫生中心分子生物学实验室，浙江杭州 310013;2.杭州市第七人民医院  浙江大学医学院附属精神卫生中心精神科，浙江杭州 310013;3.杭州市第七人民医院  浙江大学医学院附属精神卫生中心检验科，浙江杭州 310013

[摘要] 目的 探讨5-羟色胺转运体启动子区（5-HTTLPR）基因多态性与轮班护士睡眠质量的关系。 方法 选取2018年10月至2019年10月在本院从事轮班制工作的101例护士为研究对象，根据匹兹堡睡眠质量指数量表（PSQI）总分评定睡眠质量，其中睡眠障碍组（>7分）45例，睡眠正常组（≤7分）56例。采集血液，测定5-HTTLPR基因多态性，比较两组各基因型及各等位基因的频率分布，分析5-HTTLPR基因多态性与轮班护士睡眠质量的关联性。 结果 睡眠障碍组轮班护士主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍各因子得分及总分均明显高于睡眠正常组，差异均有统计学意义（P<0.05）;睡眠障碍组与睡眠正常组5-HTTLPR基因型及等位基因频率分布比较，差异均有统计学意义（P<0.05），其中睡眠障碍组SS基因型和S等位基因频率分别为64.44%、78.89%，均高于睡眠正常组（41.07%、60.71%），SS基因型者发生睡眠障碍的危险性是LL型的4.623倍（95%CI：1.153～18.542），S等位基因携带者发生睡眠障碍的危险性是L等位基因携带者的3.929倍（95%CI：1.024～15.065）。 结论 5-HTTLPR基因多态性与轮班护士睡眠质量有关，S等位基因可能是轮班护士发生睡眠障碍的易感基因。

[关键词] 轮班护士;睡眠质量;5-HTTLPR;基因多态性

[中图分类号] R749.7          [文献标识码] B          [文章编号] 1673-9701（2021）12-0167-04

Relation of gene polymorphisms in the 5-hydroxytryptamine transporter-linked promoter region and sleep quality of nurses taking shifts

YAN Pan1   WANG Ping2   LI Jing1   WANG Shengdong1   WANG Shuqi1   FANG Yue3   SONG Mingfen1

1.Laboratory of Molecular Biology， Hangzhou Seventh People′s Hospital， Affiliated Mental Health Centre， Zhejiang University School of Medicine， Hangzhou   310013， China; 2.Department of Psychiatry， Hangzhou Seventh People′s Hospital， Affiliated Mental Health Centre， Zhejiang University School of Medicine， Hangzhou 310013， China; 3.Department of Clinical Laboratory， Hangzhou Seventh People′s Hospital， Affiliated Mental Health Centre， Zhejiang University School of Medicine， Hangzhou   310013， China

[Abstract] Objective To explore the relationship between gene polymorphism of 5-hydroxytryptamine transporter-linked promoter region（5-HTTLPR） and the sleep quality of nurses taking shifts. Methods A total of 101 nurses who were working in shifts in our hospital from October 2018 to October 2019 were selected as the study subjects. The total score of the Pittsburgh Sleep Quality Index Scale（PSQI） was used to evaluate sleep quality. Among them， 45 cases were in the sleep disorder group（>7 points） and 56 cases were in the sleep normal group（≤7 points）. The blood was collected and the 5-HTTLPR gene polymorphism was determined. The frequency distribution of each genotype and allele was compared between the two groups， and the correlation between 5-HTTLPR gene polymorphism and sleep quality of nurses taking shifts was analyzed. Results The scores of subjective sleep quality， time spent falling into sleep， sleep duration， sleep efficiency， sleep disturbance， and daytime dysfunction and total scores of nurses taking shifts in the sleep disorder group were significantly higher than those in the sleep normal group， and the differences were statistically significant（P<0.05）; frequency distribution of 5-HTTLPR genotype and allele were compared between the sleep disorder group and the sleep normal group， and the differences were statistically significant（P<0.05）. Among them， the SS genotype and S allele frequencies in the sleep disorder group were 64.44% and 78.89%， which were higher than those in the sleep normal group（41.07% and 60.71%）. People with SS genotype were 4.623 times as risky to have sleep disorders as those with LL genotype（95%CI： 1.153-18.542）， and carriers of S alleles were 3.929 times as risky to have sleep disorders as carriers of L alleles（95%CI： 1.024-15.065）. Conclusion The 5-HTTLPR gene polymorphism is related to the sleep quality of nurses taking shifts. The S allele may be a susceptibility gene for sleep disorders in those nurses.

[Key words] Nurses taking shifts; Sleep quality; 5-HTTLPR; Gene polymorphism

近年来，因睡眠质量问题所带来的医疗费用增加和工作效率下降已成为社会广泛关注的公共卫生问题[1]。轮班护士由于工作环境及服务对象特殊，昼夜节律紊乱，其睡眠问题更是不容忽视[2]。以往研究表明，年龄、婚姻状况、倒夜班年限等可能是影响护士睡眠质量的因素[3]，但在这些因素相近的情况下，护士群体中不同个体的睡眠质量也有所差异。近年来……