高强度间歇训练在心脏移植术后患者心脏康复中应用的Meta分析

Effects of high intensity interval training in cardiac rehabilitation of patients after heart transplantation:a Meta-analysis

目的:探讨高强度间歇训练(HIIT)在心脏移植术后患者心脏康复中的应用效果。方法:根据检索词检索中国知网、维普网、万方数据库、中国生物医学文献数据库、Web of Science、PubMed、Cochrane Library、EMBase、EBSCO,检索时限为建库至2022年1月31日。经2名研究者筛选文献、提取信息与质量评价后,采用RevMan 5.4软件进行Meta分析。结果:根据纳排标准最终纳入10篇英文文献,其中试验组191例、对照组212例,共403例患者。Meta分析结果显示,在心脏移植术后患者的心脏康复运动中,HIIT可以提高患者心肺功能运动试验中的峰值摄氧量[ MD=1.98,95%置信区间( CI):0.55~3.41, P=0.007]、变时性反应中的峰值心率( MD=6.93,95% CI:2.62~11.24, P=0.002),改善肌肉运动能力( MD=337.18,95% CI:12.02~62.35, P=0.04),但两组在收缩压、舒张压、峰值收缩压、峰值舒张压、静息心率、呼吸交换率方面的比较差异均无统计学意义( P>0.05)。以干预周期、心脏移植术后康复运动启动时间对峰值摄氧量进行亚组分析,结果显示干预周期≤12周或启动时间>6周时,干预组和对照组峰值摄氧量比较差异均有统计学意义( P<0.01)。 结论:HIIT有效改善了心脏移植术后患者的峰值摄氧量、峰值心率、肌肉运动能力,且在患者心脏移植术后康复运动启动时间>6周或干预周期≤12周时,HIIT对峰值摄氧量的影响显著。

Objective To explore the effect of high intensity interval training(HIIT)on cardiac rehabilitation in patients after heart transplantation.Methods According to the search terms,the search was conducted on China National Knowledge Infrastructure,VIP,WanFang Data,China Biology Medicine disc,Web of Science,PubMed,Cochrane Library,Embase,and EBSCO.The search time limit was from the establishment of the database to January 31,2022.After 2 researchers screened the article,extracted information,and evaluated the quality,a Meta-analysis was conducted using RevMan 5.4 software.Results According to the inclusion and exclusion criteria,10 English articles were selected,including 191 patients in the intervention group and 212 patients in the control group,with a total of 403 patients.Meta-analysis showed that during cardiac rehabilitation exercise in patients after heart transplantation,HIIT could improve peak oxygen uptake in cardiopulmonary function exercise testing[MD=1.98,95%confidence interval(CI)(0.55,3.41),P=0.007],peak heart rate in chronotropic responses[MD=6.93,95%CI(2.62,11.24),P=0.002],and muscle exercise ability[MD=337.18,95%CI(12.02,62.35),P=0.04].There was no statistically significant difference in systolic blood pressure,diastolic blood pressure,peak systolic blood pressure,peak diastolic blood pressure,resting heart rate and respiratory exchange rate between the two groups(P>0.05).A subgroup analysis of peak oxygen uptake was conducted based on the intervention period and the start time of rehabilitation exercise after heart transplantation.The results showed that there were statistically significant differences in peak oxygen uptake between the intervention group and the control group when the intervention period was≤12 weeks or the start time was>6 weeks(P<0.01).Conclusions HIIT effectively improves the peak oxygen uptake,peak heart rate,and muscle exercise activity of patients after heart transplantation.HIIT has a significant impact on peak oxygen uptake when the rehabilitation exercise start time after heart transplantation is>6 weeks or the intervention period is≤12 weeks.