高强度间歇训练与中等强度持续训练对冠心病患者心肺功能影响的Meta分析  

Effects of High-intensity Interval Training Versus Moderate-intensity Continuous Training on Cardiorespiratory Fitness in Patients with Coronary Heart Disease:a Meta-analysis

作　　者：李大鑫 朱俊英[1] 陈平[1] LI Daxin;ZHU Junying;CHEN Ping(Department of Physical Exercise,Ocean University of China,Qingdao 266100,China)

机构地区：[1]中国海洋大学体育系,山东省青岛市266100

出　　处：《中国全科医学》2021年第35期4525-4534,共10页Chinese General Practice

基　　金：2017年青岛市社会科学规划项目(No.QDSKL1701029)。

摘　　要：背景冠心病(CHD)是心血管疾病的头号杀手,患病率和发病率一直居高不下,运动作为CHD患者的重要干预手段,一直受到广泛关注。高强度间歇训练(HIIT)与中等强度持续训练(MICT)对于改善CHD患者的心肺功能均显示出有效性,但研究结果尚存争议。因此,选择更合理的运动干预手段,对CHD患者的康复至关重要。目的探讨HIIT与MICT对CHD患者心肺功能的影响,为CHD患者运动处方的制订提供合理依据。方法计算机检索PubMed、EMBase、The Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普网和万方数据知识服务平台,搜集应用HIIT与MICT干预CHD患者心肺功能的文献,检索时限均为建库至2020年11月。收集第一作者、发表时间、国家、总样本、性别、年龄、运动类型、运动周期、运动频率、运动处方(HIIT、MICT)、结局指标〔峰值摄氧量(VO_(2)peak),无氧阈(VO_(2)AT),最大心率(HRmax),血压(BP),呼吸交换比率(RER),CO_(2)通气当量斜率(VE/VCO_(2)Slope),静息心率(HRrest)〕等信息,采用Cochrane偏倚风险评估工具对纳入的研究进行方法学质量评估,采用Review Manage 5.3和Stata 15.1软件进行统计学分析。结果共纳入了12篇文献,其中存在低、中、高风险的研究分别为3篇、8篇和1篇。纳入研究总样本量为618例,其中接受HIIT、MICT干预的样本量分别为305例和313例。Meta分析结果显示:HIIT对VO_(2)peak〔MD=1.63,95%CI(0.64,2.62),P=0.001〕、VO_(2)AT〔MD=2.62,95%CI(0.82,4.42),P=0.004〕、HRmax〔MD=5.41,95%CI(2.28,8.53),P=0.0007〕、SBP〔MD=3.16,95%CI(0.26,6.06),P=0.03〕的改善效果均优于MICT。两种运动模式对RER〔MD=0.01,95%CI(-0.01,0.03),P=0.27〕、VE/VCO_(2)Slope〔MD=-0.26,95%CI(-1.87,1.34),P=0.75〕、HRrest〔MD=1.19,95%CI(-0.42,2.80),P=0.15〕、DBP〔MD=2.56,95%CI(-0.21,5.32),P=0.07〕的改善效果比较,差异无统计学意义。亚组分析结果显示,对于干预周期在12周及以Background Among cardiovascular diseases,coronary heart disease(CHD)is the leading cause of death globally,with stubbornly high prevalence and incidence.Exercise has been widely concerned as an important intervention for CHD,and it is essential to choose an appropriate exercise rehabilitation program.Both high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)have proved to be effective in improving the cardiorespiratory fitness in CHD,but which is more superior is still a controversial.Objective To explore the effect of HIIT versus MICT on cardiorespiratory fitness in CHD,providing a basis for the formulation of an appropriate exercise rehabilitation program for patients with CHD.Methods Databases of PubMed,EMBase,The Cochrane Library,Web of Science,China Biomedical Literature Database,CNKI,CQVIP and Wanfang Data knowledge service platform were searched from inception to November 2020 for randomized controlled trials(RCTs)about effects of HIIT versus MICT on cardiorespiratory fitness in patients with CHD.Information including the first author,year of publication,country,size,gender,and age of the sample,type,duration,frequency,and program(HIIT or MICT)of the intervention,and outcomes〔peak oxygen uptake(VO_(2)peak),oxygen uptake at the anaerobic threshold(VO_(2)AT),maximum heart rate(HRmax),blood pressure,respiratory exchange ratio(RER),minute ventilation-to-carbon dioxide output(VE/VCO_(2))slope,resting heart rate(HRrest)〕was collected.Methodological quality was evaluated by Cochrane risk-of-bias tool.Statistical analysis was carried out using Review Manage 5.3 and Stata 15.1.Results A total of 12 RCTs were included,among which 3 were rated low risk of bias,8 were rated moderate risk,and 1 was rated high risk,involving 618 cases(305 with HIIT,and 313 with MICT).Meta-analysis showed that HIIT elicited more notable effects in improving patients'VO_(2)peak〔MD=1.63,95%CI(0.64,2.62),P=0.001〕、VO_(2)AT〔MD=2.62,95%CI(0.82,4.42),P=0.004〕、HRmax〔MD=5.41,95%CI(2.28,8.53),P=0.

关 键 词：冠心病 高强度间歇训练 中等强度持续训练 心肺功能 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]