高强度和中等强度运动训练对冠心病患者心肺功能的影响：一项荟萃分析。
Effects of high-intensity and moderate-intensity exercise training on cardiopulmonary function in patients with coronary artery disease: A meta-analysis.
作者信息
Zheng Liying, Pan Deng, Gu Yimeng, Wang Rumeng, Wu Yanyan, Xue Mei
机构信息
National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, China.
出版信息
Front Cardiovasc Med. 2022 Sep 20;9:961414. doi: 10.3389/fcvm.2022.961414. eCollection 2022.
PURPOSE
The study aims to evaluate the effects of high-intensity and moderate-intensity exercise training on cardiopulmonary function and exercise endurance in patients with coronary artery diseases (CAD).
METHODS
We performed a systematic search of the English and Chinese databases from their inception to March 2022. Randomized controlled trials (RCTs) were included to compare high-intensity and moderate-intensity exercise training on cardiopulmonary function in patients with CAD. The primary outcomes included peak oxygen uptake (peak VO) and anaerobic threshold (AT). The secondary outcomes included left ventricular ejection fraction (LVEF), exercises duration (ED), respiratory exchange ratio (RER), resting heart rate (RHR), peak heart rate (PHR) and oxygen pulse (O pulse). The continuous variables were expressed as mean differences (MD) along with their corresponding standard deviations (SD), and the I test was applied in the assessment of heterogeneity.
RESULTS
After systematically literature search, 19 studies were finally selected for our meta-analysis ( = 1,036), with 511 patients in the experimental group (high-intensity exercise) and 525 patients in the control group (moderate-intensity exercise). The results showed that high-intensity exercise significantly increased patients' Peak VO [MD = 2.67, 95% CI (2.24, 3.09), < 0.00001], LVEF [MD = 3.60, 95% CI (2.17, 5.03), < 0.00001], ED [MD = 37.51, 95% CI (34.02, 41.00), < 0.00001], PHR [MD = 6.86, 95% CI (4.49, 9.24), < 0.00001], and O pulse [MD = 0.97, 95% CI (0.34, 1.60), = 0.003] compared with moderate-intensity exercise. However, there were no significant differences in AT [MD = 0.49, 95% CI (-0.12, 1.10), = 0.11], RER [MD = 0.00, 95% CI (-0.01, 0.02), = 0.56], and RHR [MD = 1.10, 95% CI (-0.43, 2.63), = 0.16].
CONCLUSION
Our results show that high-intensity exercise training has more significant positive effects compared with moderate-intensity exercise training in improving peak VO, LVEF, ED, PHR and O pulse in patients with CAD, while no significant differences were observed in AT, RER and RHR. To sum up, high-intensity exercise training is better than moderate-intensity exercise training in improving cardiopulmonary function and exercise endurance in patients with CAD.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42022328475), https://www.crd.york.ac.uk/PROSPERO/.
目的
本研究旨在评估高强度和中等强度运动训练对冠状动脉疾病（CAD）患者心肺功能和运动耐力的影响。
方法
我们对英文和中文数据库从建库至2022年3月进行了系统检索。纳入随机对照试验（RCT）以比较高强度和中等强度运动训练对CAD患者心肺功能的影响。主要结局包括峰值摄氧量（peak VO₂）和无氧阈（AT）。次要结局包括左心室射血分数（LVEF）、运动持续时间（ED）、呼吸交换率（RER）、静息心率（RHR）、峰值心率（PHR）和氧脉搏（O₂脉搏）。连续变量以均数差（MD）及其相应标准差（SD）表示，采用I²检验评估异质性。
结果
经过系统的文献检索，最终选择19项研究进行我们的荟萃分析（n = 1,036），其中实验组（高强度运动）511例患者，对照组（中等强度运动）525例患者。结果显示，与中等强度运动相比，高强度运动显著提高了患者的peak VO₂[MD = 2.67，95%CI（2.24，3.09），P < 0.00001]、LVEF[MD = 3.60，95%CI（2.17，5.03），P < 0.00001]、ED[MD = 37.51，95%CI（34.02，41.00），P < 0.00001]、PHR[MD = 6.86，95%CI（4.49，9.24），P < 0.00001]和O₂脉搏[MD = 0.97，95%CI（0.34，1.60），P = 0.003]。然而，AT[MD = 0.49，95%CI（-0.12，1.10），P = 0.11]、RER[MD = 0.00，95%CI（-0.01，0.02），P = 0.56]和RHR[MD = 1.10，95%CI（-0.43，2.63），P = 0.16]无显著差异。
结论
我们的结果表明，与中等强度运动训练相比，高强度运动训练在改善CAD患者的peak VO₂、LVEF、ED、PHR和O₂脉搏方面具有更显著的积极作用，而在AT、RER和RHR方面未观察到显著差异。综上所述，高强度运动训练在改善CAD患者心肺功能和运动耐力方面优于中等强度运动训练。
系统评价注册
PROSPERO（CRD42022328475），https://www.crd.york.ac.uk/PROSPERO/。
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