北京大学学报(医学版) ›› 2023, Vol. 55 ›› Issue (3): 488-494. doi: 10.19723/j.issn.1671-167X.2023.03.015
姬学朝1,刘珊1,王万州1,赵烨彤1,李陆一1,张文楼1,沈国锋2,邓芙蓉1,3,*(),郭新彪1,*()
Xue-zhao JI1,Shan LIU1,Wan-zhou WANG1,Ye-tong ZHAO1,Lu-yi LI1,Wen-lou ZHANG1,Guo-feng SHEN2,Fu-rong DENG1,3,*(),Xin-biao GUO1,*()
摘要:
目的: 探究室内总挥发性有机物(total volatile organic compounds,TVOC)短期暴露与年轻女性夜间心率变异性(heart rate variability,HRV)的关联。方法: 采用定组研究设计,于2021年12月至2022年4月期间对北京市某高校50名年轻女性进行两次重复调查。每次调查期间,使用室内空气质量检测仪对研究对象室内TVOC浓度进行实时监测。室内温湿度、噪声、二氧化碳和颗粒物浓度分别采用温湿度仪、噪声监测仪、二氧化碳仪及多通道颗粒物监测仪进行实时监测,并采用12导联动态心电图仪测量HRV指标。采用混合效应模型分析TVOC与HRV指标的关联及暴露-反应关系,并使用双污染物模型检验结果的稳定性。结果: 50名女性的平均年龄为(22.5±2.3)岁,平均体重指数为(20.4±1.9) kg/m2。研究期间室内TVOC浓度的中位数(四分位间距)为0.069(0.046) mg/m3,室内温度、相对湿度、二氧化碳浓度、噪声水平及细颗粒物浓度的中位数(四分位间距)分别为24.3(2.7) ℃、38.5%(15.0%)、0.1%(0.1%)、52.7(5.8) dB(A)及10.3(21.5) μg/m3。室内TVOC短期暴露与研究对象HRV的时域及频域指标改变显著相关,且多数HRV指标发生最显著改变的暴露时间窗为1 h。室内TVOC的1 h滑动平均浓度每增加0.01 mg/m3,研究对象心跳间期标准偏差(standard deviation of all normal to normal intervals,SDNN)、连续5 min心跳间期平均标准偏差(standard deviation of average normal to normal intervals,SDANN)及相邻心跳差值超过50 ms与总正常心跳间距个数比值(percentage of adjacent normal to normal intervals differing by more than 50 ms,pNN50)分别降低1.89%(95%CI:-2.28%~-1.50%)、1.92%(95%CI:-2.32%~-1.51%)及0.64%(95%CI:-1.13%~-0.14%),而总功率(total power,TP)、极低频功率(very low frequency power,VLF)及低频功率(low frequency power,LF)分别降低3.52%(95%CI:-4.30%~-2.74%)、5.01%(95%CI:-6.21%~-3.79%)及4.36%(95%CI:-5.16%~-3.55%)。暴露-反应关系曲线显示,当浓度超过0.1 mg/m3时,室内TVOC与SDNN、SDANN、TP、VLF线性负相关。双污染物模型提示,在控制室内噪声及细颗粒物因素后上述结果稳健。结论: 室内TVOC短期暴露与年轻女性的夜间HRV改变存在负相关,本研究为相关防控措施提供了重要的科学依据。
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