风湿性心脏瓣膜置换术后患者体温近日节律的变化

The body temperature change of circadian rhythm in patients after cardiac valve replacement

目的监测风湿性心脏瓣膜置换术后患者的体温变化，探讨其体温近日节律特征及影响因素。方法选择2012年4～6月在福建省某三级甲等医院施行心脏瓣膜置换术的患者67例，连续24h监测术后患者的体温，通过余弦法分析其体温近日节律特征．采用主成分分析法建立生物节律模型，评价患者的生物节律特征，并应用多元线性回归分析对影响患者体温节律特征的因素进行分析。结果风湿性心脏瓣膜置换术后患者体温呈现明显的近日节律特征（P〈0．05），其中值（Mesor，M）、振幅（Amplitude，A）、位相（Acrophase，φ）分别为（37．61±0．08），（0．10±0．09），-33（-355．00，-119．00）。本研究发现，患者的性别、体外循环时间对生物节律的影响较大（P〈0．05），结论尽管风湿性心脏瓣膜置换术后部分患者的体温近日节律消失，但术后患者体温整体呈现近日节律变化，通过营造自然的光照昼夜节律、缩短体外循环时间等措施能够减少对患者术后体温近日节律的干扰。

Objective To monitor the changes of body temperature in patients after cardiac valve replacement and to explore the characteristics and influencing factors of circadian rhythm. Methods Sixty-seven patients after cardiac valve replacement were recruited in the study. The body temperature were monitored and the circadian rhythm were analyzed by using cosine curve. The biological rhythm model was developed by using principal component analysis and the influencing factors of the circadian rhythm were analyzed by using multiple linear regression analysis. Results The body temperature of patients after cardiac valve replacement demonstrated typical circadian rhythm（P〈0.05）. The scores of the temperature mesor, amplitude and acrophase were（37.6±0.08）, （0.10±0.09） and -33（-355,-119）,respectively. Gender and cardiopulmonary bypass time had significant influence on the biological rhythms of body temperature. Conclusion Although the circadian rhythm disappeared in some patients after cardiac valve replacement,most of them still existed. Some measures,such as building natural circadian thythm of light,shortening cardiopulmonary bypass time,may decrease the distraction on circadian rhythm of body temperature.