作者：罗江安，贺惠娟

单位：

430065湖北省武汉市，湖北中医药大学护理学院 通信作者：贺惠娟，E-mail：hhjiabei@hbtcm.edu.cn

Units：

Nursing College, Hubei University of Traditional Chinese Medicine, Wuhan 430065, China Correspnding author: HE Huijuan, E-mail: hhjiabei@hbtcm.edu.cn

关键词：

心力衰竭; 高强度间歇训练; 心脏康复; 安全性; 不良事件; Meta分析;

Keywords：

Heart failure; High intensity interval training; Cardiac rehabilitation; Safety; Adverse events; Meta-analysis

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.054

Funds：

湖北省卫生健康委员会科研项目（WJ2021M212）

摘要：

背景近年心力衰竭发病人群逐渐年轻化,且其发病率呈逐年上升趋势,年病死率高达40%。高强度间歇训练(HIIT)是心脏康复的新兴治疗手段,但其治疗心血管疾病患者的有效性及安全性仍存在争议。目的 采用Meta分析探讨HIIT治疗心力衰竭患者的有效性及安全性。方法 计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统及PubMed、Cochrane Library、Embase公开发表的HIIT或HIIT联合其他运动训练方式治疗心力衰竭患者有效性及安全性的随机对照试验,HIIT组为采用HIIT或HIIT联合其他运动训练方式(如抗阻运动训练等)的患者,非HIIT组为不采取任何运动训练或采用除HIIT以外的其他训练方式的患者。采用Review Manager 5.3统计学软件进行Meta分析。结果 初步检出文献178篇,根据文献纳入与排除标准筛选后最终纳入8篇文献,包含354例患者,其中HIIT组179例、非HIIT组175例。Meta分析结果显示,HIIT组患者峰值摄氧量〔均数差(MD)=1.27,95%CI(0.94,1.59),P<0.001〕、左心室射血分数〔MD=3.97,95%CI(3.55,4.38),P<0.001〕高于非HIIT组,6分钟步行距离长于非HIIT组〔MD=43.03,95%CI(14.98,71.08),P=0.003〕。两组患者不良事件发生率比较,差异无统计学意义〔相对危险度(RR)=1.62,95%CI(0.63,4.19),P=0.32〕。结论 HIIT可有效提高心力衰竭患者的心功能及运动耐量,但安全性仍有待进一步明确。

Abstract：

【Abstract】　Background In recent years, the incidence of heart failure is gradually becoming younger and increasingyear by year, and the annual mortality rate is as high as 40%. High intensity interval training (HIIT) has became an emergingtreatment for cardiac rehabilitation, however, its effectiveness and safety in the treatment of patients with cardiovascular diseasesare still controversial. Objective To investigate the efficacy and safety of HIIT in the treatment of patients with heart failureby meta-analysis. Methods CNKI, Wanfang Data, VIP, SinoMed and Cochrane Library, PubMed, Embase databases weresearched on online for randomized controlled trials reporting the efficacy and safety of HIIT or HIIT combined with other exercisemodalities in the treatment of patients with heart failure. Patients in the HIIT group used HIIT or HIIT combined with otherexercise methods (such as resistance exercise training, etc. ) , patients in the non-HIIT group did not take any exercise training orused other training methods other than HIIT. Meta-analysis was performed using Review Manager 5.3 statistical software. ResultsA total of 178 literature were initially detected, and 8 literature were finally included after screening according to the inclusionand exclusion criteria, including 354 patients, 179 cases in the HIIT group and 175 cases in the non-HIIT group. Meta-analysisresults showed that, peak oxygen uptake [mean difference (MD) =1.27, 95%CI (0.94, 1.59) , P < 0.001] , left ventricular ejectionfraction [MD=3.97, 95%CI (3.55, 4.38) , P < 0.001] in the HIIT group were higher than those in the non-HIIT group, 6-minutewalking distance was longer than that in the non-HIIT group [MD=43.03, 95%CI (14.98, 71.08) , P=0.003] . There was nostatistically significant difference in the incidence of adverse events between the two groups [relative risk (RR) =1.62, 95%CI (0.63,4.19) , P=0.32] . Conclusion HIIT can effectively improve cardiac function and exercise tolerance in patients with heart failure,and its safety remains to be further clarified.

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