高强度间歇训练与中强度持续训练对心力衰竭患者心脏康复影响的Meta分析

Influence of high-intensity interval training and medium-intensity continuous training on cardiac rehabilitation in patients with heart failure:a Meta-analysis

目的系统性评价高强度间歇训练(HIIT)与中强度持续训练(MCT)对心力衰竭(心衰,HF)患者心脏康复的影响。方法检索PubMed、EMbase、Cochrane Library、中国知网及万方数据库,检索时间为2000年1月1日至2020年5月1日。由两名研究者独立筛选文献、提取资料以及按照Jadad量表评价文献质量,采用Revman 5.3软件进行Meta分析。结果共纳入9篇文献,321例HF患者。Meta分析结果显示,与MCT组相比,HIIT可显著提高HF患者的pVO2水平(WMD=2.56ml/kg·min,95%CI:2.18~2.93,P<0.00001)、6分钟步行试验结果(WMD=43.03m,95%CI:14.98~71.08,P=0.003)以及左室射血分数(WMD=43.03%,95%CI:14.98~71.08,P=0.003),而对收缩压(WMD=2.20mmHg,95%CI:-0.05~4.45,P=0.06)和舒张压(WMD=2.42mmHg,95%CI:-4.37~9.21,P=0.48)无显著影响。结论与MCT相比,HIIT在8~12周内可显著提高HF患者的心肺功能、运动能力以及左室射血分数,有助于改善HF的远期预后,可能是用于HF患者心脏康复的有效运动策略。

Objective To systematically review the influence of high-intensity interval training(HIIT)and medium-intensity continuous training(MCT)on cardiac rehabilitation in patients with heart failure(HF).Methods The databases of PubMed,EMbase,Cochrane Library,CNKI and WanFang Data were retrieved from 2000 to May 1,2020.The data was screened and extracted and the quality was reviewed according to Jadad scale by 2 researchers independently.A Meta-analysis was conducted by using Revman 5.3 software.Results There were totally 9 documents and 321 HF patients included.The results of Meta-analysis showed that HIIT improved significantly pVO2 level(WMD=2.56ml/kg·min,95%CI:2.18~2.93,P<0.00001),6-minute walk test(6MWT,WMD=43.03m,95%CI:14.98~71.08,P=0.003)and left ventricular ejection fraction(LVEF,WMD=43.03%,95%CI:14.98~71.08,P=0.003),but had no significant influence on systolic blood pressure(SBP,WMD=2.20mmHg,95%CI:-0.05~4.45,P=0.06)and diastolic blood pressure(DBP,WMD=2.42mmHg,95%CI:-4.37~9.21,P=0.48)compared with MCT.Conclusion Compared with MCT,HIIT can significantly enhance cardiopulmonary function,motor ability and LVEF within 8 weeks to 12 weeks,and improve long-term prognosis of HF,which may be a effective exercise strategy in for cardiac rehabilitation HF patients.