摘要
目的系统评价康复运动疗法对冠心病心肌梗死治疗的有效性和安全性。方法计算机检索自建库至2013年3月Cochrane图书馆临床对照试验资料库(CCRCT)、Embase、PubMed、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、万方数据库、维普数据库(VIP),收集康复运动疗法治疗心肌梗死的试验,对康复运动疗法对冠心病心肌梗死患者治疗的疗效和安全性进行评价,使用RevMan 5.0软件进行Meta分析。结果按纳入和排除标准共纳入14项研究,共1410例患者,结果显示康复运动疗法可改善心肌梗死患者预后:①康复组最大运动负荷高于对照组(SMD=1.87,95%CI:1.65~2.10,P<0.00001);②康复组最大代谢当量高于对照组(SMD=0.56,95%CI:0.34~0.79,P<0.00001);③康复组最大耗氧量高于对照组(SMD=1.38,95%CI:1.19~1.57,P<0.00001);④康复组基础心率较对照组减慢(SMD=-0.64,95%CI:-0.79^-0.49,P<0.00001);⑤康复组心率峰值高于运动组(SMD=0.76,95%CI:0.61~0.91,P<0.00001);⑥康复组运动后一分钟的心率变异性的提高(SMD=0.98,95%CI:0.79~1.17,P<0.00001);⑦康复组较对照组提高左室射血分数(SMD=0.29,95%CI:0.15~0.43,P<0.00001)。⑧康复组患者死亡率低于对照组(OR=0.19,95%CI:0.10~0.33,P<0.00001)。结论根据目前研究结果,规范康复运动治疗可明显改善冠心病心肌梗死患者预后,提高运动能力并降低患者死亡率。
Objective To review systematically the effectiveness and safety of rehabilitation exercise therapy on the patients with myocardial infarction （MI） of coronary heart disease （CHD）.Methods The databases of CCRCT, Embase, PubMed, CNKI, CBM, WangFang Database and VIP Database were retrieved with computers for collecting randomized controlled trials （RCT） about rehabilitation exercise therapy in treatment of MI of CHD from database establishment time until Mar. 2013. The curative effect and safety of rehabilitation exercise therapy were reviewed and given a Meta-analysis by using RevMan 5.0 software.Results There were totally 14 RCT included involving 1410 cases. The results showed that rehabilitation exercise therapy can improve the prognosis of the patients. ①The maximal sports load was higher in rehabilitation group than that in control group （SMD=1.87, 95%CI： 1.65-2.10,P〈0.00001）. ②The maximal metabolic equivalent was higher in rehabilitation group than that in control group （SMD=0.56, 95%CI： 0.34~0.79,P〈0.00001）. ③The maximal oxygen consumption was higher in rehabilitation group than that in control group （SMD=1.38, 95%CI： 1.19~1.57,P〈0.00001）. ④The basal heart rate was lower in rehabilitation group than that in control group （SMD=-0.64, 95%CI： -0.79~ -0.49, P〈0.00001）. ⑤The peak heart rate was higher in rehabilitation group than that in control group （SMD=0.76, 95%CI： 0.61~0.91,P〈0.00001）. ⑥The heart rate variability after one-minute sport was improved in rehabilitation group （SMD=0.98, 95%CI： 0.79~1.17,P〈0.00001）. ⑦LVEF increased in rehabilitation group compared with control group （SMD=0.29, 95%CI： 0.15~0.43,P〈0.00001）. ⑧The mortality was lower in rehabilitation group than that in control group （OR=0.19, 95%CI： 0.10~0.33,P〈0.00001）.Conclusion According to current study results, the standardized rehabilitation exercise therapy can significantly improve the prognosis, athletic ability and reduce mortality in the patients w
出处
《中国循证心血管医学杂志》
2013年第6期583-587,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
安徽省科研计划项目(12010402116)
关键词
康复运动疗法
冠心病
心肌梗死
预后
META分析
Rehabilitation exercise therapy
Coronary heart disease
Myocardial infarction
Prognosis
Meta-analysis
