【摘要】 目的 探讨低体温对风湿性心脏病术后患者心脏代谢需求及心肌功能的影响。方法 选取2021至2024年成都市第三人民医院收治的80例风湿性心脏病(rheumatic heart disease, RHD)患者分为观察组和对照组，每组40例。观察组体外循环液体加温仪设定的温度为33.5℃,完成心脏瓣膜置换手术。对照组体外循环液体加温仪设定的温度为37℃,完成心脏瓣膜置换手术。比较2组患者心脏代谢需求及心肌功能的差异。结果 观察组和对照组的心率和平均动脉压在组间、不同时点以及组间和不同时点差异无统计学意义(P>0.05)。在组间、不同时点以及组间和不同时点，观察组的CK-MB水平显著低于对照组(P<0.05),cTn I水平也均显著低于对照组(P<0.001)。结论 将温度设定为37.5℃能够有效保持手术过程中的血流动力学稳定，提高心脏复跳成功率，并减轻心肌损伤。更多还原

【Abstract】 Objective To evaluate the effects of mild hypothermia during cardiopulmonary bypass on cardiometabolic demand and myocardial function in patients undergoing valve surgery for rheumatic heart disease(RHD).Methods From 2021 to 2024, 80 RHD patients undergoing valve replacement in the Third People’s Hospital of Chengdu were randomized into two groups(n=40 each). In the hypothermia(observation) group, the temperature of the cardiopulmonary bypass(CPB) perfusate was set to 33.5°C. In the normothermia(control) group, the perfusate temperature was set to 37.0°C. Heart rate, mean arterial pressure, and markers of myocardial injury(CK-MB and cardiac troponin I [cTnI]) were recorded at predefined perioperative time points and compared between groups.Results Heart rate and mean arterial pressure did not differ significantly between groups, across time points, or for group–time interactions(P>0.05), indicating comparable hemodynamic control in both cohorts. In contrast, markers of myocardial injury showed significant group, time, and interaction effects. CK-MB and cTnI levels were significantly lower in the hypothermia group than in the normothermia group(CK-MB: P<0.05; cTnI: P<0.001), indicating reduced perioperative myocardial injury with mild hypothermia.Conclusion Maintaining a perfusate temperature of 33.5°C during surgery helps preserve hemodynamic stability, improves the success rate of cardiac defibrillation, and mitigates myocardial injury.更多还原