輪班工作與心血管疾病的關係

The relationship between shift work and cardiovascular disease

輪班工作（shift work）已成為現今社會常見、高需求性的工作型態之一，近幾10年來，因輪班工作影響身體健康已是不爭的事實，尤其與心血管疾病（cardiovascular disease,CVD）的發生有明顯的關連性。動脈粥狀硬化，之前被認為是一般脂質堆積於血管的疾病，但後來研究證明它是一種持續性的發炎。發炎反應指標除了可從傳統因子判斷外，現今認為C-反應蛋白（C-reactive protein,CRP）和氧化壓力之間，有著互相牽連關係。CRP主要是由細胞激素濃度上升刺激肝臟細胞所產生的物質，當發炎反應產生，則CRP被大量釋放至血液中；而另有研究證明，氧化壓力所產生的發病機制和動脈粥狀硬化反應過程（發炎反應）是相同。因此，在發炎指標的判斷上，除依傳統心血管疾病因子外，現今CRP或氧化壓力等參數，對心血管疾病的預測，或許可提供另一種判斷方式。基於此，本文將以文獻整理方式，介紹輪班工作與心血管疾病的關係，及引發心血管疾病的成因（氧化壓力）與發炎因子（CRP）參與的機制，期能提供輪班工作族群對心血管疾病風險預測的另一種思維。

Shift workers are one of the most common and needed work forces in the market. However, it has been shown in recent decades that shift work adversely affects the public health, especially the elevation of the risk of cardiovascular disease (CVD). Atherosclerosis was considered to be a disease due to intravascular lipid accumulation, but now it is proved to be a condition characterized as consistent inflammation. In addition to the known factors, it is also regarded that C-reactive protein (CRP) is correlated with oxidative stress. CRP is a substance released by liver cells by the induction of cytokines, and is released in large amounts when an inflammatory reaction occurs. Evidence indicates that the pathogenesis by way of oxidative stress is equivalent to the progress of atherosclerosis (inflammatory reaction). Hence, it is expected that parameters including CRP or oxidative stress, along with the known factors, can be utilized as indicators of inflammation for the prediction of the risk of CVDs. Literature review was used in the study to explore the relationship between shift work and CVD, and the causes of CVD (oxidative stress) and the effect of inflammatory factors (CRP) in order to establish a new horizon in the prediction of the risk of CVDs in the shift workers.