5种运动方式对心血管疾病及高风险中老年人心功能影响的网状Meta分析  

The effect of 5 exercise modes on cardiac function of middle-aged and elderly people with or at high risk of cardiovascular disease:a network Meta-analysis

作　　者：李瑾 杨玉婷 张培珍 Li Jin;Yang Yuting;Zhang Peizhen(School of Sport Medicine and Rehabilitation,Beijing Sport University,Beijing 100084,China)

机构地区：[1]北京体育大学运动医学与康复学院,北京100084

出　　处：《护理学杂志》2022年第22期36-43,82,共9页Journal of Nursing Science

基　　金：国家重点研发计划课题(2022YFC2010201);北京体育大学自主科研课题(校2020045)。

摘　　要：目的 探讨不同运动方式对患有心血管疾病和心血管疾病高风险中老年人心功能的改善效果,为其心功能的改善和心血管疾病防治提供循证建议。方法 检索PubMed、Cochrane Library、Embase、Web of science、中国知网、中国生物医学文献服务系统、维普中文期刊全文数据库、万方医学网、万方数据知识服务平台,纳入运动对中老年人心功能影响的随机对照试验。采用RevMan5.4和Stata16.0进行相关的统计学分析。结果 共纳入48篇随机对照试验研究,3 073例受试者。在降低心率方面,不同运动方式的优劣顺序为:间歇有氧运动(SUCRA=73.30)、持续有氧运动(SUCRA=72.00)、高强度间歇运动(SUCRA=67.50)、持续有氧运动结合抗阻运动(SUCRA=62.80)、抗阻运动(SUCRA=20.10)。在提高左室射血分数方面,间歇有氧运动显著优于持续有氧运动结合抗阻运动(MD=2.88,95%CI:0.01~5.76);与持续有氧运动相比,间歇有氧运动(MD=4.02,95%CI:1.72~6.31)、抗阻运动(MD=2.32,95%CI:0.17~4.48)效果更好;不同运动方式的优劣顺序为:间歇有氧运动(SUCRA=95.10)、抗阻运动(SUCRA=72.40)、持续有氧运动结合抗阻运动(SUCRA=51.70)、高强度间歇运动(SUCRA=50.80)、持续有氧运动(SUCRA=29.50)。在心率变异性方面,运动干预对升高正常R-R间期标准差有良好作用(MD=9.05,95%CI:3.10~15.00,P<0.05),对改善低频与高频功率比值效果不显著(MD=-0.18,95%CI:-0.56~0.20,P>0.05)。结论 运动可以通过降低安静心率、提高左室射血分数、改善心率变异性来增强中老年人的心功能。间歇有氧运动、持续有氧运动、高强度间歇运动、抗阻运动、持续有氧运动结合抗阻运动都能够在一定程度上改善中老年人的心功能,其中,间歇有氧运动对中老年人心功能的改善效果更为全面,在降低心率和提高左室射血分数方面,可能是更有效的干预措施。Objective To conduct a network Meta-analysis quantifying the effects of different kinds of exercise on middle-aged and elderly people with or at a high risk of cardiovascular disease(CVD), and to provide evidence-based suggestions on cardiac function improvement and CVD prevention and treatment. Methods We searched Pubmed, the Cochrane Library, Embase, Web of Science, CNKI, Sinomed, VIP, Wanfang Med, and Wanfang Data to retrieve RCTs on effect of exercise on cardiac function of middle-aged and elderly people. Data were analyzed using RevMan5.4 and Stata16.0. Results We included 48 RCTs that involved 3 073 participants. In terms of HR reduction, the exercises were ranked as follows: interval aerobic exercise(SUCRA=73.30), continuous aerobic exercise(SUCRA=72.00), high-intensity interval training(SUCRA=67.50), continuous aerobic exercise combined with resistance training(SUCRA=62.80), and resistance training(SUCRA=20.10). In terms of LVEF increase, the effects of interval aerobic exercise were better than continuous aerobic exercise combined with resistance training(MD=2.88,95%CI:0.01-5.76);compared with continuous aerobic exercise, interval aerobic exercise(MD=4.02,95%CI:1.72-6.31), and resistance training(MD=2.32,95%CI:0.17-4.48) were better;different kinds of exercise were ranked as follows: interval aerobic exercise(SUCRA=95.10), resistance training(SUCRA=72.40), continuous aerobic exercise combined with resistance training(SUCRA=51.70), high-intensity interval training(SUCRA=50.80), continuous aerobic exercise(SUCRA=29.50). In terms of heart rate variability(HRVS), exercise had a good effect on SDNN increase(MD=9.05,95%CI:3.10-15.00,P<0.05) and little effect on LF/HF radio(MD=-0.18,95%CI:-0.56-0.20,P>0.05). Conclusion Exercise can improve cardiac function of middle-aged and elderly people by decreasing HR, raising LVEF, and improving HRV. Interval aerobic exercise, continuous aerobic exercise, high-intensity interval training, resistance training, and continuous aerobic exercise combined with resistance traini

关 键 词：心血管疾病 中老年人 运动方式 间歇有氧运动 持续有氧运动 抗阻运动 心功能 网状Meta分析 

分 类 号：R473.5[医药卫生—护理学]