基于健康生态学模型的健康管理干预对心血管病危险人群影响的Meta分析

Meta analysis of the eff ects of health management interventions on people at risk of cardiovascular disease based on the health ecology model

目的分析、评价基于健康生态学模型的健康管理对心血管病危险人群的干预研究。方法系统检索中国知网、中国生物医学文献数据库、万方数据库、维普中文科技期刊、PubMed、Proquest、Cochrane Library、Web of Science,收集有关基于健康生态学模型的健康管理对心血管病危险人群进行干预的研究,检索时限为建库至2021年9月。由2名研究者根据纳排标准独立筛选文献和提取数据,应用Cochrane Handbook5.1.0危险偏倚评估量表分析纳入文献的偏倚危险,采用RevMan 5.3统计软件对资料进行Meta分析。结果最终纳入8篇研究,合计样本量10545例。Meta分析结果显示,基于健康生态学模型的健康管理能有效降低心血管病危险人群的BMI(MD=-0.45,95%CI:-0.71~-0.2),但是在改善血压(收缩压,MD=-1.66,95%CI:-5.95~2.63;舒张压,MD=-0.84,95%CI:-1.75~0.06),提高心血管病危险人群中等身体活动水平(SMD=0.67,95%CI:-0.07~1.4)方面,差异均无统计学意义(P>0.05)。结论基于健康生态学模型的健康管理干预能改善心血管病危险人群的身体质量指数水平,但在中等程度活动水平、血压方面的干预效果还需进一步验证。

Objective To analyse and evaluate the intervention study of health management based on health ecology model on people at risk of cardiovascular disease.Methods The systematically searched the China Knowledge Network,China Biomedical Literature Database,Wanfang Database,Wipro Chinese Scientific and Technical Journals,PubMed,Proquest,Cochrane Library,and Web of Science to collect studies on the interventions of health management based on health ecology model on people at risk of cardiovascular diseases,and the search time was from the establishment of the database to September 2021,and the search time was from the establishment of the database to the end of the year.September.Literature was independently screened and data were extracted by 2 researchers according to the NAE criteria,and the risk of bias of the included literature was analysed by applying the Cochrane Handbook 5.1.0 Hazard of Bias Assessment Scale,and the data were subjected to Meta-analysis by using RevMan 5.3 statistical software.Results 8 studies with a combined sample size of 10,545 cases werefinally included.Meta-analysis showed that health management based on the health ecology model was effective in reducing BMI(MD=-0.45,95%CI:-0.71~-0.2)in people at risk of cardiovascular disease,but was not effective in improving blood pressure(systolic blood pressure,MD=-1.66,95%CI:-5.95~2.63,diastolic blood pressure,MD=-0.84,95%CI:-1.75~0.06),and improving the level of moderate physical activity(SMD=0.67,95%CI:-0.07~1.4)in people at risk of cardiovascular disease,none of the differences were statistically significant(P>0.05).Conclusion Health management intervention based on health ecology model can improve the level of body mass index in people at risk of cardiovascular disease,but the effect of the intervention in terms of moderate activity level and blood pressure needs to be further verified.