生活方式干预对心血管代谢性共病病人影响的Meta分析  

Influence of lifestyle intervention on patients with cardiovascular multimorbidity:a Meta-analysis

作　　者：曾婧晖 宋凯 力娜 张静 杨龙辉 朱瑞芳[1,2] ZENG Jinghui;SONG Kai;LI Na;ZHANG Jing;YANG Longhui;ZHU Ruifang(School of Nursing,Shanxi Medical University,Shanxi 030001 China;First Hospital of Shanxi Medical University)

机构地区：[1]山西医科大学护理学院,山西030001 [2]山西医科大学第一医院

出　　处：《循证护理》2025年第8期1459-1467,共9页Chinese Evidence-Based Nursing

基　　金：山西省社会科学界联学会2024至2025年度重点课题研究项目,编号:SSKLZDKT2024041。

摘　　要：目的:系统评价生活方式干预对心血管代谢性共病病人代谢综合征各项指标的影响,为心血管代谢性共病人群的疾病预防提供循证证据。方法:计算机检索中国知网、万方数据库、维普数据库、PubMed、the Cochrane Library、Web of Science、EMbase数据库中关于心血管代谢性共病与生活方式干预相关的随机对照试验(RCT),检索时限从2014年1月1日—2024年9月1日,由2名研究员独立进行文献检索、资料提取和偏倚风险评价,使用RevMan 5.4.1软件进行Meta分析。结果:共纳入18篇文献,涉及1596例病人。Meta分析结果显示,生活方式干预能有效改善心血管代谢性共病病人的高密度脂蛋白胆固醇[WMD=0.10,95%CI(0.00,0.20),P=0.04]、空腹血糖[WMD=-1.23,95%CI(-1.97,-0.48),P=0.001]、三酰甘油[WMD=-0.48,95%CI(-0.73,-0.24),P=0.0001]、收缩压[WMD=-7.73,95%CI(-12.06,-3.39),P=0.0005]及腰围[WMD=-3.20,95%CI(-6.16,-0.24),P=0.03];亚组分析结果显示,当干预时间≥3个月时,生活方式干预能改善心血管代谢性共病病人高密度脂蛋白胆固醇、空腹血糖、三酰甘油、收缩压、腰围水平,差异均有统计学意义(P<0.05)。结论:现有证据表明生活方式干预能有效改善心血管代谢性共病病人代谢综合征的相关指标,具有副作用低、操作简便、非侵入性等优点;但干预时间<3个月的效果有待进一步验证。Objective:To systematically evaluate the impact of lifestyle interventions on various indicators of metabolic syndrome in patients with cardiometabolic multimorbidity,and to provide evidence-based insights for disease prevention in this population.Methods:Randomized controlled trials(RCTs)related to cardiometabolic multimorbidity and lifestyle interventions were retrieved from databases including CNKI,WanFang Database,VIP,PubMed,the Cochrane Library,Web of Science,and EMbase.The search period spanned from January 1,2014,to September 1,2024.Totally two researchers independently conducted literature screening,data extraction,and risk of bias assessment.Meta-analysis was performed using RevMan 5.4.1 software.Results:A total of 18 articles were included.It involved 1596 patients.Meta-analysis results demonstrated that lifestyle interventions significantly improved high-density lipoprotein choesterol(HDL-C)(WMD=0.10,95%CI 0.00-0.20,P=0.04),fasting blood glucose(FBG)(WMD=-1.23,95%CI-1.97--0.48,P=0.001),triglycerides(TG)(WMD=-0.48,95%CI-0.73--0.24,P=0.0001),systolic blood pressure(SBP)(WMD=-7.73,95%CI-12.06--3.39,P=0.0005),and waist circumference(WC)(WMD=-3.20,95%CI-6.16--0.24,P=0.03).Subgroup analysis revealed that lifestyle interventions lasting more than 3 months significantly improved HDL-C,FBG,TG,SBP,and WC levels in patients with cardiometabolic multimorbidity,with statistically significant differences(P<0.05).Conclusions:Current evidence suggests that lifestyle interventions can effectively improve metabolic syndrome-related indicators in patients with cardiometabolic multimorbidity,offering advantages such as low side effects,simplicity,and non-invasiveness.However,the efficacy of interventions lasting less than 3 months requires further validation.

关 键 词：生活方式 心血管代谢性共病 代谢综合征 META分析 循证护理 

分 类 号：R473.5[医药卫生—护理学]