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经皮冠状动脉介入治疗后运动心脏康复在冠心病患者中的作用:一项随机对照试验的荟萃分析

The role of exercise-based cardiac rehabilitation after percutaneous coronary intervention in patients with coronary artery disease: a meta-analysis of randomised controlled trials.

作者信息

Li Tong, Jiang Han, Ding Jun

机构信息

China-Japan Union Hospital of JiLin University, Changchun City, P.R. China.

出版信息

Acta Cardiol. 2024 Apr;79(2):127-135. doi: 10.1080/00015385.2023.2266650. Epub 2024 Mar 11.

Abstract

BACKGROUND

this study was designed to analyse patient outcomes using a combination of PCI and exercise-based cardiac rehabilitation compared with PCI alone.

METHODS

PCI can improve the survival rate of patients with coronary artery disease, but it can also cause vascular endothelial cell injury, thrombosis, and even restenosis. Early cardiac rehabilitation exercise is crucial for patients with coronary heart disease after PCI. Five databases were examined for randomised controlled trials involving early cardiac rehabilitation exercise and standard treatment in patients with coronary heart disease after PCI. The search period lasted from the creation of the database (2006) until December 2022. The outcomes including angina, arrhythmia, coronary restenosis, left ventricular ejection fraction, left ventricular end diastolic diameter, 6-min walk distance, total cholesterol, heart rate, systolic blood pressure and diastolic blood pressure. RevMan 5.3 was used to analyse the data, and the Cochrane Collaboration was used to assess the quality of evidence.

RESULTS

A total of 1231 patients were enrolled in this study. Angina pectoris (RR = 0.24, 95% CI [0.10, 0.57],  = 0.001), Arrhythmia (RR = 0.17, 95% CI [0.05, 0.55],  = 0.003), Coronary artery restenosis (RR = 0.10, 95% CI [0.01, 0.76],  = 0.03).

CONCLUSION

Exercise after PCI improves LVEF, enhances 6MWD, lowers HR and minimises the risk of angina, arrhythmia and coronary artery restenosis in CHD patients. Exercise had no discernible effect on LVEDD, TC, SBP, or DBP.

摘要

背景

本研究旨在分析与单纯经皮冠状动脉介入治疗(PCI)相比,PCI联合基于运动的心脏康复对患者预后的影响。

方法

PCI可提高冠心病患者的生存率,但也可导致血管内皮细胞损伤、血栓形成,甚至再狭窄。早期心脏康复运动对PCI术后冠心病患者至关重要。检索了五个数据库,以查找有关PCI术后冠心病患者早期心脏康复运动和标准治疗的随机对照试验。检索期从数据库创建(2006年)持续到2022年12月。观察指标包括心绞痛、心律失常、冠状动脉再狭窄、左心室射血分数、左心室舒张末期内径、6分钟步行距离、总胆固醇、心率、收缩压和舒张压。使用RevMan 5.3分析数据,并采用Cochrane协作网评估证据质量。

结果

本研究共纳入1231例患者。心绞痛(RR = 0.24,95%CI[0.10, 0.57],P = 0.001)、心律失常(RR = 0.17,95%CI[0.05, 0.55],P = 0.003)、冠状动脉再狭窄(RR = 0.10,95%CI[0.01, 0.76],P = 0.03)。

结论

PCI术后运动可改善冠心病患者的左心室射血分数,增加6分钟步行距离,降低心率,并将心绞痛、心律失常和冠状动脉再狭窄的风险降至最低。运动对左心室舒张末期内径、总胆固醇、收缩压或舒张压没有明显影响。

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