Chen Yu-Chi, Tsai Jen-Chen, Liou Yiing-Mei, Chan Paul
1 Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan.
2 School of Nursing, National Yang-Ming University, Taipei, Taiwan.
Eur J Cardiovasc Nurs. 2017 Jun;16(5):397-408. doi: 10.1177/1474515116684407. Epub 2016 Dec 19.
Exercise interventions apparently reduce the risks of and prevent coronary artery disease (CAD). Developing an exercise intervention for patients with CAD is a rapidly expanding focus worldwide. The results of previous studies are inconsistent and difficult to interpret across various types of exercise programme.
This study aimed to update prior systemic reviews and meta-analyses in order to determine the overall effects of endurance exercise training on patients with CAD.
The databases (PubMed, Medline, CINAHL, EMBASE and Cochrane Library) were searched for the interventions published between January 1, 2000, and May 31, 2015. Comprehensive meta-analysis software was used to evaluate the heterogeneity of the selected studies and to calculate mean differences (MDs) while considering effect size.
A total of 18 studies with 1286 participants were included. Endurance exercise interventions at a moderate to high training intensity significantly reduced resting systolic blood pressure (MD: -3.8 mmHg, p = 0.01) and low-density lipoprotein cholesterol (MD: -5.5 mg/dL, p = 0.02), and increased high-density lipoprotein cholesterol (MD: 3.8 mg/dL, p < 0.001). There were also significant positive changes in peak oxygen consumption (MD: 3.47 mL/kg/min, p < 0.001) and left ventricular ejection fraction (MD: 2.6%, p = 0.03) after the interventions. Subgroup analysis results revealed that exercise interventions of 60-90 minutes per week with a programme duration of >12 weeks had beneficial effects on functional capacity, cardiac function and a number of cardiovascular risk factors.
Endurance exercise training has a positive effect on major modifiable cardiovascular risk factors and functional capacity. Nurses can develop endurance exercise recommendations for incorporation into care plans of clinically stable CAD patients following an acute cardiac event or revascularisation procedure.
运动干预显然可降低冠心病（CAD）风险并预防该病。为CAD患者制定运动干预措施是全球迅速扩大的关注重点。先前研究结果不一致，且难以在各类运动项目间进行解读。
本研究旨在更新先前的系统评价和荟萃分析，以确定耐力运动训练对CAD患者的总体影响。
检索数据库（PubMed、Medline、CINAHL、EMBASE和Cochrane图书馆），查找2000年1月1日至2015年5月31日期间发表的干预措施。使用综合荟萃分析软件评估所选研究的异质性，并在考虑效应量的同时计算平均差异（MD）。
共纳入18项研究，1286名参与者。中等到高强度训练强度的耐力运动干预显著降低静息收缩压（MD：-3.8 mmHg，p = 0.01）和低密度脂蛋白胆固醇（MD：-5.5 mg/dL，p = 0.02），并升高高密度脂蛋白胆固醇（MD：3.8 mg/dL，p < 0.001）。干预后峰值耗氧量（MD：3.47 mL/kg/min，p < 0.001）和左心室射血分数（MD：2.6%，p = 0.03）也有显著正向变化。亚组分析结果显示，每周运动干预60 - 90分钟且项目持续时间>12周对功能能力、心脏功能和一些心血管危险因素有有益影响。
耐力运动训练对主要可改变的心血管危险因素和功能能力有积极影响。护士可为急性心脏事件或血运重建术后临床稳定的CAD患者制定耐力运动建议，纳入护理计划。
