成人先天性心脏病的运动训练：系统评价和荟萃分析。
Exercise Training in Adults With Congenital Heart Disease: A SYSTEMATIC REVIEW AND META-ANALYSIS.
机构信息
Departments of Rehabilitation (Mss Li, Chen, and Zhou and Dr Du) and Pediatric Cardiology (Drs Chen and Sun), Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China; School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China (Ms Yang); and Department of Rehabilitation, Chongming Branch of Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (Ms Song and Dr Du).
出版信息
J Cardiopulm Rehabil Prev. 2019 Sep;39(5):299-307. doi: 10.1097/HCR.0000000000000420.
BACKGROUND
Evidence from many studies demonstrates that regular exercise has a favorable effect on cardiovascular disease, but it is still unclear whether adults with congenital heart disease (ACHD) benefit from exercise training. The aim of this study was to assess the effects of exercise training on ACHD.
METHODS
PubMed, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health, and Web of Science databases were searched. Differences were expressed using mean difference (MD) with 95% CI. The statistical analysis was performed using Review Manager (RevMan 5.3). Outcomes, including cardiorespiratory fitness, neurohumoral activation (NT-proBNP levels), rating of perceived exertion (Borg scale), and safety status, were investigated.
RESULTS
Nine trials with 403 ACHD were included. The following outcomes were statistically significant: peak (Equation is included in full-text article.)O2 (MD = 1.96, 95% CI, 0.70-3.23; P = .002); maximal workload (MD = 11.46, 95% CI, 7.06-15.87; P < .00001); and maximal exercise duration (MD = 2.04, 95% CI, 1.00-3.07; P = .0001). But no significant decrease was reported regarding neurohumoral activation or the rating of perceived exertion. Furthermore, no major adverse events were reported. The overall quality of evidence ranged from moderate to very low.
CONCLUSIONS
Evidence was underpowered to suggest that exercise training is effective in the management of ACHD. Future studies with longer follow-up are needed.
背景
许多研究的证据表明，有规律的运动对心血管疾病有有益的影响，但目前仍不清楚先天性心脏病（ACHD）患者是否能从运动训练中获益。本研究旨在评估运动训练对 ACHD 的影响。
方法
检索了 PubMed、EMBASE、Cochrane 图书馆、护理和联合健康累积索引以及 Web of Science 数据库。使用均数差（MD）和 95%置信区间（CI）表示差异。使用 Review Manager（RevMan 5.3）进行统计分析。调查了心肺功能适应性、神经激素激活（NT-proBNP 水平）、感知用力评分（Borg 量表）和安全性状况等结果。
结果
纳入了 9 项包含 403 例 ACHD 的试验。以下结果具有统计学意义：峰值（Equation is included in full-text article.）O2（MD = 1.96，95%CI，0.70-3.23；P =.002）；最大工作量（MD = 11.46，95%CI，7.06-15.87；P <.00001）；以及最大运动时间（MD = 2.04，95%CI，1.00-3.07；P =.0001）。但是，神经激素激活或感知用力评分并没有显著降低。此外，没有报告重大不良事件。证据的总体质量从中等到极低不等。
结论
目前证据不足以表明运动训练对 ACHD 的管理有效。需要进行随访时间更长的未来研究。
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