Oldridge Neil
University of Wisconsin School of Medicine & Public Health, Aurora Cardiovascular Services, Aurora Medical Group, Glendale, Milwaukee, WI 53217, USA.
Future Cardiol. 2012 Sep;8(5):729-51. doi: 10.2217/fca.12.34.
Cardiac rehabilitation that includes either exercise training alone or exercise training in addition to psychosocial, risk factor management and/or educational interventions is considered a Class I indication [i.e., useful and effective] for patients with coronary heart disease. This overview of six independent cardiac rehabilitation meta-analyses published since 2000 includes a total of 71 randomized clinical trials (n = 13,824 patients) and clearly demonstrates significant clinical outcomes (reduced all-cause and cardiac mortality, nonfatal reinfarction and reduced hospitalization rates) and significant positive changes in modifiable risk factors (total cholesterol, triglycerides and systolic blood pressure). Despite the observation that the elderly, females, minority ethnic groups, low socioeconomic status patients and patients with comorbidities have not been well represented in the randomized clinical trials. Recent guidelines in the UK and USA have concluded with the recommendation that cardiac rehabilitation is reasonable and necessary and should be promoted by healthcare professionals, including senior medical staff.
心脏康复，包括单独的运动训练或除心理社会、危险因素管理和/或教育干预之外的运动训练，被认为是冠心病患者的I类适应证[即有用且有效]。这篇对2000年以来发表的六项独立心脏康复荟萃分析的综述，总共纳入了71项随机临床试验（n = 13824例患者），并清楚地表明了显著的临床结局（全因死亡率和心脏死亡率降低、非致命性再梗死以及住院率降低）以及可改变危险因素（总胆固醇、甘油三酯和收缩压）的显著正向变化。尽管观察到老年人、女性、少数族裔、社会经济地位低的患者以及合并症患者在随机临床试验中的代表性不足。英国和美国最近的指南得出结论，建议心脏康复是合理且必要的，应由包括高级医务人员在内的医疗保健专业人员予以推广。
